Namvar Zohoori, MD, MPH, PhD Chronic Disease Director, Associate Director for Science Arkansas Department of Health Ass

2. Principal Investigators: Namvar Zohoori, MD, MPH, PhD Arkansas Department of Health (ADH) Fay W Boozeman College of Public Health (COPH) Co-investigators LeaVonne Pulley, PhD Fay W Boozeman College of Public Health Camille Jones, MD, MPH [Arkansas Minority Health Commission; UAMS] The ARCHES Team

3. Collaborators and Funding Agencies CDC Epidemiology and Surveillance Branch ADH Programs Heart Disease and Stroke Prevention Program Diabetes Prevention and Control Program Tobacco Prevention and Cessation Program Oral Health Program Infectious Diseases Branch Arkansas Public Health Laboratories Abbott Renal Care Arkansas Minority Health Commission Blue and You Foundation American Heart Association The ARCHES Team

4. Examination Management Services Inc. (EMSI) Central Reference Laboratories (CRL-Medinet) Survey Research Center, UA, Little Rock Survey Research Center, UA, Fayetteville Fred Hutchinson Cancer Research Center The ARCHES Team

5. One of four CDC-funded states State-level health examination surveys Obtain State estimates of critical CV variables Three-stage clustered sample design Over-sample a priority population (blacks) Civilian, non-institutionalized, English speaking, 18 and over 1385 subjects in study ARCHES Project

6. Basic Counts

7. HH Income ComparisonSampling Frame by Disposition

9. EMSI Interviewers

10. Home Visit Kit

11. Home Visit Kit

12. ARCHES Respondents

16. Has the prevalence of hypertension in adults declined in recent years? Are some groups more likely to have hypertension compared to others? What proportion of adults have prehypertension? Are adults with hypertension aware that they have it? What is the proportion of adults with hypertension who are treated with antihypertensive medication? What percentage of adults treated with antihypetensive medication have their BP controlled? Questions asked of the data

17. Questions based on…

18. Hypertension: systolic BP = 140 mm Hg or diastolic BP = 90 mm Hg or currently taking medication to lower high BP. Prehypertension: systolic BP 120–139 mm Hg or diastolic BP 80–89 mm Hg, and not pharmacologically treated for high BP. Awareness of hypertension: affirmative response to “Have you ever been told by a doctor or health professional that you had hypertension, also called high blood pressure?” Definitions

19. Currently taking medication to lower BP: Among all hypertensives, defined by affirmative responses to: “Because of your high blood pressure/hypertension, have you ever been told to take prescribed medicine?”; and “Are you now following this advice to take prescribed medicine?” Controlled Hypertension: systolic BP <140 mmHg and diastolic BP < 90 mmHg among those currently taking medication to lower BP. Definitions

20. Blood pressure measurement

21. Truth in advertising

22. NHANES data: Age-adjusted to US population ARCHES data: Not age-adjusted Weighted to state population Combined final weight consisting of: Structural weight Household weight Post-stratification weight Truth in advertising

36. What percentage of adults treated with antihypertensive medicationDo NOT BELEIVE that taking blood pressure medicine exactly as prescribed is important

37. What percentage of adults treated with antihypertensive medicationBELIEVE that once blood pressure comes down, they can stop taking medicines

38. What percentage of adults treated with antihypertensive medicationBELIEVE that taking blood pressure medicine is more trouble than it’s worth

39. What percentage of adults treated with antihypertensive medicationBELIEVE that blood pressure medicines do not work as well if you take them all the time

40. Prevalence of adult hypertension: 48% 55% higher than self-reported BRFSS data Blacks >> Whites Prevalence of adult prehypertension: 28% Whites >> Blacks 18-39 >> 40-59 18-39 >> 60+ Hypertension awareness: 75% Blacks > Whites 60+ > 18-59 Treatment of hypertension: 67% 60+ >> 18-59 60+M >> 18-59M 18-59F >> 18-59M Control of hypertension: 59% Summary

41. Increased awareness at state level Presentations to key stakeholders Health Department Senior Management County Health Officers Governor’s Round Table on Health State Surgeon General State Board of Health Legislative Interim Study on Hypertension and Stroke Analyses and publications in development, on Hypertension Cholesterol Diabetes Stress and reactions to race Methods paper Hypertension White Paper in development Data use to date and plans

42. 3-county pilot initiative Hypertension ‘Institute’ being planned Data use guidelines and agreements already developed Researcher use encouraged Student use encouraged SES factors in Na, K, Ca and Mg intake Analysis of serum samples for cotinine Development of ‘hypertension’ intervention Data use to date and plans

43. Chem 24 Panel CBC Lipid profile (including total cholesterol, LDL, HDL, triglycerides) Fasting Glucose HbA1c (known diabetics) Fasting serum insulin High sensitivity C Reactive Protein Homocysteine Cystatin-C Serum Creatinine Urinary ACR Calcium Phosphate PTH Serum cotinine (to be performed at ADH) Blood and Urine Tests Performed

44. Basic Counts