National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- (-) Blood Pressure (26)
- Cardiovascular Conditions (5)
- Care Management (2)
- Children/Adolescents (1)
- Chronic Conditions (2)
- Community-Based Practice (1)
- Depression (1)
- Diabetes (3)
- Diagnostic Safety and Quality (5)
- Disparities (2)
- Emergency Department (4)
- Evidence-Based Practice (3)
- Guidelines (3)
- Healthcare Costs (2)
- Healthcare Delivery (2)
- Healthcare Utilization (1)
- Health Literacy (1)
- Health Status (1)
- Heart Disease and Health (1)
- Home Healthcare (1)
- Lifestyle Changes (1)
- Low-Income (1)
- Maternal Care (2)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (6)
- Nutrition (1)
- Obesity (2)
- Outcomes (2)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (3)
- Policy (1)
- Pregnancy (2)
- Prevention (2)
- Primary Care (4)
- Provider: Physician (1)
- Quality Measures (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (4)
- Risk (4)
- Screening (5)
- Shared Decision Making (2)
- Social Determinants of Health (2)
- Stroke (2)
- Tobacco Use (1)
- U.S. Preventive Services Task Force (USPSTF) (2)
- Women (3)
- Young Adults (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 26 Research Studies DisplayedTung EL, Chua RFM, Besser SA
Association of rising violent crime with blood pressure and cardiovascular risk: longitudinal evidence from Chicago, 2014-2016.
The purpose of this study was to examine the longitudinal association between rising violent crime and elevated blood pressure (BP). They analyzed 217,816 BP measurements from 17,783 adults during a temporal surge in violent crime in Chicago (2014-2016).The investigators concluded that rising violent crime was associated with increased BP during a temporal crime surge.
AHRQ-funded; HS023007.
Citation: Tung EL, Chua RFM, Besser SA .
Association of rising violent crime with blood pressure and cardiovascular risk: longitudinal evidence from Chicago, 2014-2016.
Am J Hypertens 2019 Nov 15;32(12):1192-98. doi: 10.1093/ajh/hpz134..
Keywords: Blood Pressure, Social Determinants of Health, Risk
Shahu A, Herrin J, Dhruva SS
Disparities in socioeconomic context and association with blood pressure control and cardiovascular outcomes in ALLHAT.
This study used data from the randomized clinical trial ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) to study the effect of socioeconomics and blood pressure control and cardiovascular outcomes. The study sites were stratified by their county-level median household income into income quintiles. The lowest income sites (quintile 1) were most likely to be women, black or Hispanic, have less education, to live in the South and to have fewer cardiovascular risk factors. Despite standardized treatment protocols, quintile 1 participants were less likely to have blood pressure control, and all greater all-cause mortality, heart failure hospitalizations/mortality and end-stage renal disease than the highest income participants (quintile 5).
AHRQ-funded; HS023000.
Citation: Shahu A, Herrin J, Dhruva SS .
Disparities in socioeconomic context and association with blood pressure control and cardiovascular outcomes in ALLHAT.
J Am Heart Assoc 2019 Aug 6;8(15):e012277. doi: 10.1161/jaha.119.012277..
Keywords: Blood Pressure, Cardiovascular Conditions, Disparities, Patient-Centered Outcomes Research, Medication, Prevention, Outcomes
Fabiyi CA, Reid LD, Mistry KB
AHRQ Author: Fabiyi CA, Mistry KB
Postpartum health care use after gestational diabetes and hypertensive disorders of pregnancy.
The objective of this study was to examine postpartum health care utilization after a pregnancy complicated by gestational diabetes (GD) and hypertensive disorders of pregnancy (HDP) using nationally representative data. The investigators found that women with GD/HDP did not differ from women with neither complication on postpartum utilization outcomes. Less educated women with GD/HDP were more likely to miss an office visit within 1 year postpartum than less educated women with neither complication. Certain subgroups of women were more likely to forego timely and appropriate postpartum care.
AHRQ-authored.
Citation: Fabiyi CA, Reid LD, Mistry KB .
Postpartum health care use after gestational diabetes and hypertensive disorders of pregnancy.
J Womens Health 2019 Aug;28(8):1116-23. doi: 10.1089/jwh.2018.7198..
Keywords: Medical Expenditure Panel Survey (MEPS), Maternal Care, Pregnancy, Diabetes, Blood Pressure, Women, Healthcare Utilization
Tajeu GS, Kent ST, Huang L
Antihypertensive medication nonpersistence and low adherence for adults <65 years initiating treatment in 2007-2014.
Previous evidence suggests modest improvements in antihypertensive medication adherence occurred from 2007 to 2012 among US adults >/=65 years of age. Whether adherence improved over time among adults <65 years of age is unknown. In this study, the investigators assessed trends in antihypertensive medication nonpersistence and low adherence among 379 658 commercially insured adults <65 years of age initiating treatment in 2007-2014 using MarketScan claims.
AHRQ-funded; HS024262; HS013852.
Citation: Tajeu GS, Kent ST, Huang L .
Antihypertensive medication nonpersistence and low adherence for adults <65 years initiating treatment in 2007-2014.
Hypertension 2019 Jul;74(1):35-46. doi: 10.1161/hypertensionaha.118.12495..
Keywords: Blood Pressure, Patient Adherence/Compliance, Medication, Cardiovascular Conditions
Lor M, Koleck TA, Bakken S
Association between health literacy and medication adherence among Hispanics with hypertension.
This study examined the association between health literacy and medication adherence among Hispanic adults with hypertension. A cross-sectional survey of 1355 Hispanic adults, mostly Dominicans who self-report hypertension was conducted. After controlling for age, sex, birth country, education level, recruitment location, depression, anxiety, and sleep disturbance inadequate health literacy was associated with a lower adherence score.
AHRQ-funded; HS019853; HS022961.
Citation: Lor M, Koleck TA, Bakken S .
Association between health literacy and medication adherence among Hispanics with hypertension.
J Racial Ethn Health Disparities 2019 Jun;6(3):517-24. doi: 10.1007/s40615-018-00550-z..
Keywords: Blood Pressure, Health Literacy, Patient Adherence/Compliance, Medication, Racial and Ethnic Minorities
Anstey DE, Moise N, Kronish I
Masked hypertension: whom and how to screen?
The purpose of this study was to review issues regarding the practical implementation of screening strategies for masked hypertension. In this review, challenges to screening strategies for masked hypertension, and factors that should be considered when deciding to screen using ambulatory or home blood pressure monitoring were highlighted.
AHRQ-funded; HS024262.
Citation: Anstey DE, Moise N, Kronish I .
Masked hypertension: whom and how to screen?
Curr Hypertens Rep 2019 Apr 4;21(4):26. doi: 10.1007/s11906-019-0931-1..
Keywords: Blood Pressure, Screening
Shaffer VA, Wegier P, Valentine KD
Patient judgments about hypertension control: the role of variability, trends, and outliers in visualized blood pressure data.
Uncontrolled hypertension is a significant health problem in the United States, even though multiple drugs exist to effectively treat this chronic disease. As part of a larger project developing data visualizations to support shared decision making about hypertension treatment, the investigators conducted a series of studies to understand how perceptions of hypertension control were impacted by data variations inherent in the visualization of blood pressure (BP) data.
AHRQ-funded; HS023328.
Citation: Shaffer VA, Wegier P, Valentine KD .
Patient judgments about hypertension control: the role of variability, trends, and outliers in visualized blood pressure data.
J Med Internet Res 2019 Mar 26;21(3):e11366. doi: 10.2196/11366..
Keywords: Blood Pressure, Shared Decision Making, Patient-Centered Healthcare, Medication, Chronic Conditions
Liyanage-Don N, Fung D, Phillips E
Implementing home blood pressure monitoring into clinical practice.
The purpose of this study was to review data that supports the use of home blood pressure monitoring (HBPM) and to provide practical guidance to clinicians who wish to incorporate HBPM into their practice. Home blood pressure monitoring more accurately reflects the risk of cardiovascular events than office blood pressure measurements, and evidence supports the hypothesis that HBPM combined with clinical support improves blood pressure control. In spite of this, HBPM use remains low due to barriers between patients, clinicians, and healthcare system levels; understanding these barriers is crucial for the development of strategies to implement HBPM. This article considers how recommended best practices can facilitate the successful and effective implementation of HBPM.
AHRQ-funded; HS024262.
Citation: Liyanage-Don N, Fung D, Phillips E .
Implementing home blood pressure monitoring into clinical practice.
Curr Hypertens Rep 2019 Feb 12;21(2):14. doi: 10.1007/s11906-019-0916-0..
Keywords: Blood Pressure, Diagnostic Safety and Quality, Primary Care, Screening
Goldberg EM, Wilson T, Jambhekar B
Emergency department-provided home blood pressure devices can help detect undiagnosed hypertension.
This study researched the value of giving home blood pressure devices to patients in emergency departments (EDs) with a triage blood pressure (BP) of >= 120/80 mmHg and no history of hypertension. About 68% of the participants used the device at least 4 times. Those participants with elevated BP had follow-up with their primary care doctor 46% of the time.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Wilson T, Jambhekar B .
Emergency department-provided home blood pressure devices can help detect undiagnosed hypertension.
High Blood Press Cardiovasc Prev 2019 Feb;26(1):45-53. doi: 10.1007/s40292-019-00300-0..
Keywords: Blood Pressure, Emergency Department, Diagnostic Safety and Quality
Patil SJ, Koopman RJ, Belden J
The role of home BP monitoring: answers to 10 common questions.
This review examines what role home blood-pressure monitoring (HBPM) should take in the management of patients with hypertension. The answers to ten evidence-based questions, with reference to USPSTF recommendations, are used to provide insight. These questions include: Can HPBM be used to confirm a hypertension diagnosis? What are the diagnostic and treatment targets for HBPM? Does HBPM improve control of hypertension? Does HBPM help improve medication adherence? Does HBPM improve BP outcomes?
AHRQ-funded; HS023328.
Citation: Patil SJ, Koopman RJ, Belden J .
The role of home BP monitoring: answers to 10 common questions.
J Fam Pract 2019 Jan/Feb;68(1):29-33..
Keywords: U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Home Healthcare, Evidence-Based Practice, Care Management, Guidelines
Gooding HC, Brown CA, Wisk LE
Investing in our future: the importance of ambulatory visits to achieving blood pressure control in young adults.
In this commentary, the authors discuss an article written by King, et al. and published in 2017 in the Journal of Clinical Hypertension, entitled “The importance of frequent return visits and hypertension control among US young adults: a multidisciplinary group practice observational study.”
AHRQ-funded; K12 HS022986.
Citation: Gooding HC, Brown CA, Wisk LE .
Investing in our future: the importance of ambulatory visits to achieving blood pressure control in young adults.
J Clin Hypertens 2017 Dec;19(12):1298-300. doi: 10.1111/jch.13100..
Keywords: Ambulatory Care and Surgery, Care Management, Blood Pressure, Young Adults
Kronish IM, Kent S, Moise N
Barriers to conducting ambulatory and home blood pressure monitoring during hypertension screening in the United States.
The goal of the study was to determine the most important barriers to primary care providers' ordering ambulatory and home BP monitoring in the United States. The study found that top-ranked barriers to home BP monitoring were concerns about compliance with the correct test protocol, accuracy of tests results, out-of-pocket costs of home BP devices, and time needed to instruct patients on home BP monitoring protocol.
AHRQ-funded; HS024262.
Citation: Kronish IM, Kent S, Moise N .
Barriers to conducting ambulatory and home blood pressure monitoring during hypertension screening in the United States.
J Am Soc Hypertens 2017 Sep;11(9):573-80. doi: 10.1016/j.jash.2017.06.012..
Keywords: Blood Pressure, Primary Care, Diagnostic Safety and Quality, Screening
McClintock HF, Bogner HR
Incorporating patients' social determinants of health into hypertension and depression care: a pilot randomized controlled trial.
The objective of this study was to carry out a randomized controlled pilot trial to test the effectiveness of an integrated intervention for hypertension and depression incorporating patients' social determinants of health (enhanced intervention) versus an integrated intervention alone (basic intervention). The pilot trial results indicate integrated care management that addresses the social determinants of health for patients with hypertension and depression may be effective.
AHRQ-funded; HS023445.
Citation: McClintock HF, Bogner HR .
Incorporating patients' social determinants of health into hypertension and depression care: a pilot randomized controlled trial.
Community Ment Health J 2017 Aug;53(6):703-10. doi: 10.1007/s10597-017-0131-x.
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Keywords: Depression, Behavioral Health, Blood Pressure, Social Determinants of Health, Patient-Centered Healthcare, Healthcare Delivery
Bandi P, Goldmann E, Parikh NS
Age-related differences in antihypertensive medication adherence in Hispanics: a cross-sectional community-based survey in New York City, 2011-2012.
US Hispanics, particularly younger adults in New York City, have a higher prevalence of uncontrolled hypertension than do people of other racial/ethnic groups. This study found that in younger adults, heavy alcohol consumption, a longer duration of hypertension, and recent poor physical health were negatively associated with high adherence. In older adults, advancing age, higher education level, high knowledge of hypertension control, and insurance status were positively associated with high adherence.
AHRQ-funded; HS022961.
Citation: Bandi P, Goldmann E, Parikh NS .
Age-related differences in antihypertensive medication adherence in Hispanics: a cross-sectional community-based survey in New York City, 2011-2012.
Prev Chronic Dis 2017 Jul 13;14:E57. doi: 10.5888/pcd14.160512.
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Keywords: Blood Pressure, Medication, Patient Adherence/Compliance, Racial and Ethnic Minorities
Beckman AL, Herrin J, Nasir K
Trends in cardiovascular health of US adults by income, 2005-2014.
This research letter discusses the trends in cardiovascular health of US adults by income from 2005-2014. The investigators assessed national trends in cardiovascular risk factors by income level among adults aged 25 years and older using data from the National Health and Nutrition Examination Surveys, a nationally representative, multistage probability sample of the US population, across 5 periods: 2005 to 2006, 2007 to 2008, 2009 to 2010, 2011 to 2012, and 2013 to 2014.
AHRQ-funded; HS023000.
Citation: Beckman AL, Herrin J, Nasir K .
Trends in cardiovascular health of US adults by income, 2005-2014.
JAMA Cardiol 2017 Jul;2(7):814-16. doi: 10.1001/jamacardio.2017.1654..
Keywords: Cardiovascular Conditions, Risk, Disparities, Health Status, Blood Pressure, Obesity, Diabetes, Low-Income, Tobacco Use
Bello JK, Mohanty N, Bauer V
Pediatric hypertension: provider perspectives.
The researchers aimed to gain insights into reasons for low rates of diagnosis and treatment from primary care providers. In interviews, providers reflected on numerous barriers to diagnosis, management, and follow-up; recommendations for educational content; and how community health center systems can be improved. Findings informed development of a multifaceted intervention.
AHRQ-funded; HS024100.
Citation: Bello JK, Mohanty N, Bauer V .
Pediatric hypertension: provider perspectives.
Glob Pediatr Health 2017 Jun 6;4:2333794x17712637. doi: 10.1177/2333794x17712637.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Healthcare Delivery, Blood Pressure, Obesity, Primary Care
Tajeu GS, Mennemeyer S, Menachemi N
Cost-effectiveness of antihypertensive medication: exploring race and sex differences using data from the REasons for Geographic and Racial Differences in Stroke Study.
The researchers compared the cost-effectiveness of antihypertensive medication treatment versus no-treatment in white and black adults. They concluded that antihypertensive medication treatment is cost-saving and increases quality-adjusted life-years (QALYs) for all groups considered in the model, particularly among black adults.
AHRQ-funded; HS013852.
Citation: Tajeu GS, Mennemeyer S, Menachemi N .
Cost-effectiveness of antihypertensive medication: exploring race and sex differences using data from the REasons for Geographic and Racial Differences in Stroke Study.
Med Care 2017 Jun;55(6):552-60. doi: 10.1097/mlr.0000000000000719.
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Keywords: Medication, Blood Pressure, Healthcare Costs, Racial and Ethnic Minorities, Stroke
Goldberg EM, Wilson T, Saucier C
Achieving the BpTRUth: emergency department hypertension screening and the Centers for Medicare & Medicaid Services quality measure.
The aims of this study were to (1) assess the reliability of ED triage blood pressure (BP) as a metric to establish when the CMS threshold (>/=120/80 mm Hg), and other clinically relevant BP thresholds (>/=140/90 and >/=160/100 mm Hg) have been met; and (2) determine whether correct identification varies by gender, race, or triage acuity. At the three suggested BP thresholds, 66.1 percent, 74.0 percent, and 88.8 percent of patients were confirmed to meet the CMS threshold, respectively. There were no differences by gender, race, or triage acuity.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Wilson T, Saucier C .
Achieving the BpTRUth: emergency department hypertension screening and the Centers for Medicare & Medicaid Services quality measure.
J Am Soc Hypertens 2017 May;11(5):290-94. doi: 10.1016/j.jash.2017.03.003.
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Keywords: Blood Pressure, Emergency Department, Quality Measures, Screening, Diagnostic Safety and Quality, Quality of Care
Brousseau EC, Danilack V, Cai F
Emergency department visits for postpartum hypertension.
The purpose of this study was to describe the characteristics of women diagnosed with postpartum hypertension in an emergency department (ED) to better inform postpartum care. The investigators compared women with an ED diagnosis of hypertension to women with all other ED diagnoses and concluded that postpartum surveillance may not prevent readmission for hypertension.
AHRQ-funded; HS025013.
Citation: Brousseau EC, Danilack V, Cai F .
Emergency department visits for postpartum hypertension.
Hypertens Pregnancy 2017 May;36(2):212-16. doi: 10.1080/10641955.2017.1299171..
Keywords: Emergency Department, Blood Pressure, Maternal Care, Women
Henderson JT, Thompson JH, Burda BU
Preeclampsia screening: evidence report and systematic review for the US Preventive Services Task Force.
The researchers systematically reviewed the benefits and harms of preeclampsia screening and risk assessment for the US Preventive Services Task Force. Their review of 21 studies concluded that evidence to estimate benefits and harms of preeclampsia screening and the test performance of different screening approaches over the course of pregnancy was limited. Externally validated risk prediction models had limited applicability.
AHRQ-funded; 290201200151I.
Citation: Henderson JT, Thompson JH, Burda BU .
Preeclampsia screening: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Apr 25;317(16):1668-83. doi: 10.1001/jama.2016.18315.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Pregnancy, Blood Pressure, Screening, Evidence-Based Practice, Guidelines, Women, Prevention
Fontil V, Bibbins-Domingo K, Nguyen OK
Management of hypertension in primary care safety-net clinics in the United States: a comparison of community health centers and private physicians' offices.
The researchers examined adherence to guideline-concordant hypertension treatment practices at community health centers (CHCs) compared with private physicians' offices.: Medicaid patients at CHCs were as likely as privately insured individuals to receive a new medication for uncontrolled hypertension, whereas Medicaid patients at private physicians' offices were less likely to receive a new medication.
AHRQ-funded; HS018090.
Citation: Fontil V, Bibbins-Domingo K, Nguyen OK .
Management of hypertension in primary care safety-net clinics in the United States: a comparison of community health centers and private physicians' offices.
Health Serv Res 2017 Apr;52(2):807-25. doi: 10.1111/1475-6773.12516.
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Keywords: Blood Pressure, Primary Care, Community-Based Practice, Guidelines, Evidence-Based Practice
Diaz KM, Booth JN, 3rd, Seals SR
Physical activity and incident hypertension in African Americans: the Jackson Heart Study.
The purpose of this study was to examine the association of physical activity with incident hypertension among African Americans. It found no statistically significant associations observed for overall physical activity, or work, active living, and household-related physical activities. Results suggest that regular moderate-vigorous physical activity or sport/exercise-related physical activity may reduce the risk of developing hypertension in African Americans.
AHRQ-funded; HS023009.
Citation: Diaz KM, Booth JN, 3rd, Seals SR .
Physical activity and incident hypertension in African Americans: the Jackson Heart Study.
Hypertension 2017 Mar;69(3):421-27. doi: 10.1161/hypertensionaha.116.08398.
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Keywords: Blood Pressure, Lifestyle Changes, Racial and Ethnic Minorities, Risk
Brody A, Twiner M, Kumar A
Survey of emergency physician approaches to management of asymptomatic hypertension.
The objective of this study was to define emergency physician (EP) approaches to management of asymptomatic uncontrolled hypertension (HTN) and assess adherence to the American College of Emergency Physician clinical policies. It found that wide variability exists in EP approaches to patients with asymptomatic HTN. Treatment decisions were impacted by patient history of chronic HTN, referral from primary care providers, and magnitude of BP elevation.
AHRQ-funded; HS000011.
Citation: Brody A, Twiner M, Kumar A .
Survey of emergency physician approaches to management of asymptomatic hypertension.
J Clin Hypertens 2017 Mar;19(3):265-69. doi: 10.1111/jch.12921.
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Keywords: Blood Pressure, Emergency Department, Provider: Physician, Shared Decision Making
Tam MC, Lee R, Cascino TM
Current perspectives on systemic hypertension in heart failure with preserved ejection fraction.
Heart failure with preserved ejection fraction (HFpEF) is a prevalent but incompletely understood syndrome. Traditional models of HFpEF pathophysiology revolve around systemic hypertension (HTN) and other causes of increased left ventricular afterload leading to left ventricular hypertrophy (LVH) and diastolic dysfunction. However, emerging models attribute the development of HFpEF to systemic proinflammatory changes secondary to common comorbidities which include HTN.
AHRQ-funded; HS024567.
Citation: Tam MC, Lee R, Cascino TM .
Current perspectives on systemic hypertension in heart failure with preserved ejection fraction.
Curr Hypertens Rep 2017 Feb;19(2):12. doi: 10.1007/s11906-017-0709-2.
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Keywords: Blood Pressure, Heart Disease and Health, Cardiovascular Conditions, Stroke, Outcomes
Webb M, Fahimi S, Singh GM
Cost effectiveness of a government supported policy strategy to decrease sodium intake: global analysis across 183 nations.
This study quantified the cost effectiveness of a government policy combining targeted industry agreements and public education to reduce sodium intake in 183 countries worldwide. It concluded that a government "soft regulation" strategy combining targeted industry agreements and public education to reduce dietary sodium is projected to be highly cost effective worldwide, even without accounting for potential healthcare savings.
AHRQ-funded; HS000062.
Citation: Webb M, Fahimi S, Singh GM .
Cost effectiveness of a government supported policy strategy to decrease sodium intake: global analysis across 183 nations.
BMJ 2017 Jan 10;356:i6699. doi: 10.1136/bmj.i6699.
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Keywords: Healthcare Costs, Nutrition, Cardiovascular Conditions, Blood Pressure, Policy