Olugbenga Ogedegbe
Olugbenga Ogedegbe
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Professor of Social and Behavioral Sciences
Professor for the Department of Population Health at NYU Grossman School of Medicine
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Professional overview
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Gbenga Ogedegbe, a physician, is Professor of Population Health & Medicine, Chief Division of Health & Behavior and Director Center for Healthful Behavior Change in the Department of Population Health at the School of Medicine. Gbenga is a leading expert on health disparities research; his work focuses on the implementation of evidence-based interventions for cardiovascular risk reduction in minority populations. He is Principal Investigator on numerous NIH projects, and has expanded his work globally to Sub-Saharan Africa where he is funded by the NIH to strengthen research capacity and reduce the burden of noncommunicable diseases. He has co-authored over 250 publications and his work has been recognized by receipt of several research and mentoring awards including the prestigious John M. Eisenberg Excellence in Mentorship Award from the Agency for Healthcare Research and Quality, and the Daniel Savage Science Award. He has served on numerous scientific panels including the NIH, CDC, World Health Organization, and the European Union Research Council. Prior to joining NYU, he was faculty at Cornell Weill Medical School and Columbia University College of Physicians and Surgeons.
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Education
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MPH from Columbia University, 1999Residency, Montefiore Medical Center, Internal Medicine, 1998MD from Donetsk University, 1988
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Areas of research and study
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Access to HealthcareGlobal HealthHealth of Marginalized PopulationImplementation and Impact of Public Health RegulationsImplementation scienceStroke and Cardiovascular Disease
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Publications
Publications
Strategies for implementing and sustaining therapeutic lifestyle changes as part of hypertension management in African Americans
AbstractScisney-Matlock, M., Bosworth, H. B., Giger, J. N., Strickland, O. L., Van Harrison, R., Coverson, D., Shah, N. R., Dennison, C. R., Dunbar-Jacob, J. M., Jones, L., Ogedegbe, G., Batts-Turner, M. L., & Jamerson, K. A. (n.d.).Publication year
2009Journal title
Postgraduate MedicineVolume
121Issue
3Page(s)
147-159AbstractAfrican Americans with high blood pressure (BP) can benefit greatly from therapeutic lifestyle changes (TLC) such as diet modification, physical activity, and weight management. However, they and their health care providers face many barriers in modifying health behaviors. A multidisciplinary panel synthesized the scientific data on TLC in African Americans for efficacy in improving BP control, barriers to behavioral change, and strategies to overcome those barriers. Therapeutic lifestyle change interventions should emphasize patient self-management, supported by providers, family, and the community. Interventions should be tailored to an individual's cultural heritage, beliefs, and behavioral norms. Simultaneously targeting multiple factors that impede BP control will maximize the likelihood of success. The panel cited limited progress with integrating the Dietary Approaches to Stop Hypertension (DASH) eating plan into the African American diet as an example of the need for more strategically developed interventions. Culturally sensitive instruments to assess impact will help guide improved provision of TLC in special populations. The challenge of improving BP control in African Americans and delivery of hypertension care requires changes at the health system and public policy levels. At the patient level, culturally sensitive interventions that apply the strategies described and optimize community involvement will advance TLC in African Americans with high BP.What is the optimal interval between successive home blood pressure readings using an automated oscillometric device?
AbstractEguchi, K., Kuruvilla, S., Ogedegbe, G., Gerin, W., Schwartz, J. E., & Pickering, T. G. (n.d.).Publication year
2009Journal title
Journal of HypertensionVolume
27Issue
6Page(s)
1172-1177AbstractObjectives To clarify whether a shorter interval between three successive home blood pressure (HBP) readings (10 s vs. 1min) taken twice a day gives a better prediction of the average 24-h BP and better patient compliance. Design We enrolled 56 patients from a hypertension clinic (mean age: 60 ± 14 years; 54% female patients). The study consisted of three clinic visits, with two 4-week periods of self-monitoring of HBP between them, and a 24-h ambulatory BP monitoring at the second visit. Using a crossover design, with order randomized, the oscillometric HBP device (HEM-5001) could be programmed to take three consecutive readings at either 10-s or 1-min intervals, each of which was done for 4 weeks. Patients were asked to measure three HBP readings in the morning and evening. All the readings were stored in the memory of the monitors. Results The analyses were performed using the second -third HBP readings. The average systolic BP/diastolic BPfor the 10-s and 1-min intervals at home were 136.1± 15.8/77.5 ± 9.5 and 133.2 ± 15.5/76.9 ± 9.3 mmHg (P = 0.001/0.19 for the differences in systolic BP and diastolic BP), respectively. The 1-min BP readings were significantly closer to the average of awake ambulatory BP (131 ± 14/79 ± 10 mmHg) than the 10-s interval readings. There was no significant difference in patients' compliance in taking adequate numbers of readings at the different time intervals. Conclusion The 1-min interval between HBP readings gave a closer agreement with the daytime average BP than the 10-s interval.A practice-based trial of motivational interviewing and adherence in hypertensive African Americans
AbstractOgedegbe, G., Chaplin, W., Schoenthaler, A., Statman, D., Berger, D., Richardson, T., Phillips, E., Spencer, J., & Allegrante, J. P. (n.d.).Publication year
2008Journal title
American Journal of HypertensionVolume
21Issue
10Page(s)
1137-1143AbstractBackground: Poor medication adherence is a significant problem in hypertensive African Americans. Although motivational interviewing (MINT) is effective for adoption and maintenance of health behaviors in patients with chronic diseases, its effect on medication adherence remains untested in this population. Methods: This randomized controlled trial tested the effect of a practice-based MINT counseling vs. usual care (UC) on medication adherence and blood pressure (BP) in 190 hypertensive African Americans (88% women; mean age 54 years). Patients were recruited from two community-based primary care practices in New York City. The primary outcome was adherence measured by electronic pill monitors; the secondary outcome was within-patient change in office BP from baseline to 12 months. Results: Baseline adherence was similar in both groups (56.2 and 56.6% for MINT and UC, respectively, P = 0.94). Based on intent-to-treat analysis using mixed-effects regression, a significant time x group interaction with model-predicted posttreatment adherence rates of 43 and 57% were found in the UC and MINT groups, respectively (P = 0.027), with a between-group difference of 14% (95% confidence interval, -0.2 to -27%). The between-group difference in systolic and diastolic BP was -6.1 mm Hg (P = 0.065) and -1.4 mm Hg (P = 0.465), respectively, in favor of the MINT group. Conclusions: A practice-based MINT counseling led to steady maintenance of medication adherence over time, compared to significant decline in adherence for UC patients. This effect was associated with a modest, nonsignificant trend toward a net reduction in systolic BP in favor of the MINT group.A senior center-based pilot trial of the effect of lifestyle intervention on blood pressure in minority elderly people with hypertension
AbstractFernandez, S., Scales, K. L., Pineiro, J. M., Schoenthaler, A. M., & Ogedegbe, G. (n.d.).Publication year
2008Journal title
Journal of the American Geriatrics SocietyVolume
56Issue
10Page(s)
1860-1866AbstractOBJECTIVES: To test the feasibility, acceptability, and effect of a senior center-based behavioral counseling lifestyle intervention on systolic blood pressure (BP). DESIGN: A pre-post design pilot trial of behavioral counseling for therapeutic lifestyle changes in minority elderly people with hypertension. Participants completed baseline visit, Visit 1 (approximately 6 weeks postbaseline), and a final study Visit 2 (approximately 14 weeks postbaseline) within 4 months. SETTING: The study took place in six community-based senior centers in New York City with 65 seniors (mean age 72.29±6.92; 53.8% female; 84.6% African American). PARTICIPANTS: Sixty-five minority elderly people. INTERVENTION: Six weekly and two monthly "booster" group sessions on lifestyle changes to improve BP (e.g., diet, exercise, adherence to prescribed antihypertensive medications). MEASUREMENTS: Primary outcome was systolic BP (SBP) measured using an automated BP monitor. Secondary outcomes were diastolic BP (DBP), physical activity, diet, and adherence to prescribed antihypertensive medications. RESULTS: There was a significant reduction in average SBP of 13.0±21.1 mmHg for the intervention group (t(25)=3.14, P=.004) and a nonsignificant reduction in mean SBP of 10.6±30.0 mmHg for the waitlist control group (t(29)=1.95, P=.06). For the intervention group, adherence improved 26% (t(23)=2.31, P=.03), and vegetable intake improved 23% (t(25)=2.29, P=.03). CONCLUSION: This senior center-based lifestyle intervention was associated with a significant reduction in SBP and adherence to prescribed antihypertensive medications and diet in the intervention group. Participant retention and group attendance rates suggest that implementing a group-counseling intervention in senior centers is feasible.Barriers to optimal hypertension control
AbstractOgedegbe, G. (n.d.).Publication year
2008Journal title
Journal of Clinical HypertensionVolume
10Issue
8Page(s)
644-646AbstractThere is an obvious gap in the translation of clinical trial evidence into practice with regards to optimal hypertension control. The three major categories of barriers to BP control are patient-related, physician-related, and medical environment/health care system factors. Patient-related barriers include poor medication adherence, beliefs about hypertension and its treatment, depression, health literacy, comorbidity, and patient motivation. The most pertinent is medication adherence, given its centrality to the other factors. The most salient physician-related barrier is clinical inertia - defined, as the failure of health care providers to initiate or intensify drug therapy in a patient with uncontrolled BP. The major reasons for clinical inertia are: 1) overestimation of the amount of care that physicians provide; 2) lack of training on how to attain target BP levels; and 3) clinicians' use of soft reasons to avoid treatment intensification by adopting a "wait until next visit" approach in response to patients' excuses.Call to action on use and reimbursement for home blood pressure monitoring: A joint scientific statement from the american heart association, american society of hypertension, and preventive cardiovascular nurses association
AbstractPickering, T. G., Miller, N. H., Ogedegbe, G., Krakoff, L. R., Artinian, N. T., & Goff, D. (n.d.).Publication year
2008Journal title
HypertensionVolume
52Issue
1Page(s)
10-29AbstractHome blood pressure monitoring (HBPM) overcomes many of the limitations of traditional office blood pressure (BP) measurement and is both cheaper and easier to perform than ambulatory BP monitoring. Monitors that use the oscillometric method are currently available that are accurate, reliable, easy to use, and relatively inexpensive. An increasing number of patients are using them regularly to check their BP at home, but although this has been endorsed by national and international guidelines, detailed recommendations for their use have been lacking. There is a rapidly growing literature showing that measurements taken by patients at home are often lower than readings taken in the office and closer to the average BP recorded by 24-hour ambulatory monitors, which is the BP that best predicts cardiovascular risk. Because of the larger numbers of readings that can be taken by HBPM than in the office and the elimination of the white-coat effect (the increase of BP during an office visit), home readings are more reproducible than office readings and show better correlations with measures of target organ damage. In addition, prospective studies that have used multiple home readings to express the true BP have found that home BP predicts risk better than office BP (Class IIa; Level of Evidence A). This call-to-action article makes the following recommendations: (1) It is recommended that HBPM should become a routine component of BP measurement in the majority of patients with known or suspected hypertension; (2) Patients should be advised to purchase oscillometric monitors that measure BP on the upper arm with an appropriate cuff size and that have been shown to be accurate according to standard international protocols. They should be shown how to use them by their healthcare providers; (3) Two to 3 readings should be taken while the subject is resting in the seated position, both in the morning and at night, over a period of 1 week. A total of ≥12 readings are recommended for making clinical decisions; (4) HBPM is indicated in patients with newly diagnosed or suspected hypertension, in whom it may distinguish between white-coat and sustained hypertension. If the results are equivocal, ambulatory BP monitoring may help to establish the diagnosis; (5) In patients with prehypertension, HBPM may be useful for detecting masked hypertension; (6) HBPM is recommended for evaluating the response to any type of antihypertensive treatment and may improve adherence; (7) The target HBPM goal for treatment is <135/85 mm Hg or <130/80 mm Hg in high-risk patients; (8) HBPM is useful in the elderly, in whom both BP variability and the white-coat effect are increased; (9) HBPM is of value in patients with diabetes, in whom tight BP control is of paramount importance; (10) Other populations in whom HBPM may be beneficial include pregnant women, children, and patients with kidney disease; and (11) HBPM has the potential to improve the quality of care while reducing costs and should be reimbursed.Call to action on use and reimbursement for home blood pressure monitoring: A joint scientific statement from the American heart association, american society of hypertension, and preventive cardiovascular nurses association
AbstractPickering, T. G., Miller, N. H., Ogedegbe, G., Krakoff, L. R., Artinian, N. T., & Goff, D. (n.d.).Publication year
2008Journal title
Journal of Cardiovascular NursingVolume
23Issue
4Page(s)
299-323AbstractHome blood pressure monitoring (HBPM) overcomes many of the limitations of traditional office blood pressure (BP) measurement and is both cheaper and easier to perform than ambulatory BP monitoring. Monitors that use the oscillometric method are currently available that are accurate, reliable, easy to use, and relatively inexpensive. An increasing number of patients are using them regularly to check their BP at home, but although this has been endorsed by national and international guidelines, detailed recommendations for their use have been lacking. There is a rapidly growing literature showing that measurements taken by patients at home are often lower than readings taken in the office and closer to the average BP recorded by 24-hour ambulatory monitors, which is the BP that best predicts cardiovascular risk. Because of the larger numbers of readings that can be taken by HBPM than in the office and the elimination of the white-coat effect (the increase of BP during an office visit), home readings are more reproducible than office readings and show better correlations with measures of target organ damage. In addition, prospective studies that have used multiple home readings to express the true BP have found that home BP predicts risk better than office BP (Class IIa; Level of Evidence A). This call-to-action article makes the following recommendations: (1) It is recommended that HBPM should become a routine component of BP measurement in the majority of patients with known or suspected hypertension; (2) Patients should be advised to purchase oscillometric monitors that measure.Call to Action on Use and Reimbursement for Home Blood Pressure Monitoring: Executive Summary. A Joint Scientific Statement From the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association
AbstractPickering, T. G., Miller, N. H., Ogedegbe, G., Krakoff, L. R., Artinian, N. T., & Goff, D. (n.d.).Publication year
2008Journal title
Journal of the American Society of HypertensionVolume
2Issue
3Page(s)
192-202AbstractHome blood pressure monitoring (HBPM) overcomes many of the limitations of traditional office blood pressure (BP) measurement and is both cheaper and easier to perform than ambulatory BP monitoring. Monitors that use the oscillometric method are currently available that are accurate, reliable, easy to use, and relatively inexpensive. An increasing number of patients are using them regularly to check their BP at home, but although this has been endorsed by national and international guidelines, detailed recommendations for their use have been lacking. There is a rapidly growing literature showing that measurements taken by patients at home are often lower than readings taken in the office and closer to the average BP recorded by 24-hour ambulatory monitors, which is the BP that best predicts cardiovascular risk. Because of the larger numbers of readings that can be taken by HBPM than in the office and the elimination of the white-coat effect (the increase of BP during an office visit), home readings are more reproducible than office readings and show better correlations with measures of target organ damage. In addition, prospective studies that have used multiple home readings to express the true BP have found that home BP predicts risk better than office BP (class IIa; level of evidence A). This call-to-action article makes the following recommendations: 1) It is recommended that HBPM should become a routine component of BP measurement in the majority of patients with known or suspected hypertension; 2) Patients should be advised to purchase oscillometric monitors that measure BP on the upper arm with an appropriate cuff size and that have been shown to be accurate according to standard international protocols. They should be shown how to use them by their healthcare providers; 3) Two to three readings should be taken while the subject is resting in the seated position, both in the morning and at night, over a period of 1 week. A total of ≥12 readings are recommended for making clinical decisions; 4) HBPM is indicated in patients with newly diagnosed or suspected hypertension, in whom it may distinguish between white-coat and sustained hypertension. If the results are equivocal, ambulatory BP monitoring may help to establish the diagnosis; 5) In patients with prehypertension, HBPM may be useful for detecting masked hypertension; 6) HBPM is recommended for evaluating the response to any type of antihypertensive treatment and may improve adherence; 7) The target HBPM goal for treatment is <135/85 mm Hg or <130/80 mm Hg in high-risk patients; 8) HBPM is useful in the elderly, in whom both BP variability and the white-coat effect are increased; 9) HBPM is of value in patients with diabetes, in whom tight BP control is of paramount importance; 10) Other populations in whom HBPM may be beneficial include pregnant women, children, and patients with kidney disease; and 11) HBPM has the potential to improve the quality of care while reducing costs and should be reimbursed.Call to action on use and reimbursement for home blood pressure monitoring: Executive summary: A joint scientific statement from the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association
AbstractPickering, T. G., Miller, N. H., Ogedegbe, G., Krakoff, L. R., Artinian, N. T., & Goff, D. (n.d.).Publication year
2008Journal title
Journal of Clinical HypertensionVolume
10Issue
6Page(s)
467-476AbstractHome blood pressure monitoring (HBPM) overcomes many of the limitations of traditional office blood pressure (BP) measurement and is both cheaper and easier to perform than ambulatory BP monitoring. Monitors that use the oscillometric method are currently available that are accurate, reliable, easy to use, and relatively inexpensive. An increasing number of patients are using them regularly to check their BP at home, but although this has been endorsed by national and international guidelines, detailed recommendations for their use have been lacking. There is a rapidly growing literature showing that measurements taken by patients at home are often lower than readings taken in the office and closer to the average BP recorded by 24-hour ambulatory monitors, which is the BP that best predicts cardiovascular risk. Because of the larger numbers of readings that can be taken by HBPM than in the office and the elimination of the white-coat effect (the increase of BP during an office visit), home readings are more reproducible than office readings and show better correlations with measures of target organ damage. In addition, prospective studies that have used multiple home readings to express the true BP have found that home BP predicts risk better than office BP (class IIa; level of evidence A). This call-to-action article makes the following recommendations: (1) It is recommended that HBPM should become a routine component of BP measurement in the majority of patients with known or suspected hypertension; (2) Patients should be advised to purchase oscillometric monitors that measure BP on the upper arm with an appropriate cuff size and that have been shown to be accurate according to standard international protocols. They should be shown how to use them by their healthcare providers; (3) Two to 3 readings should be taken while the subject is resting in the seated position, both in the morning and at night, over a period of 1 week. A total of ≥12 readings are recommended for making clinical decisions; (4) HBPM is indicated in patients with newly diagnosed or suspected hypertension, in whom it may distinguish between white-coat and sustained hypertension. If the results are equivocal, ambulatory BP monitoring may help to establish the diagnosis; (5) In patients with prehypertension, HBPM may be useful for detecting masked hypertension; (6) HBPM is recommended for evaluating the response to any type of antihypertensive treatment and may improve adherence; (7) The target HBPM goal for treatment is <135/ 85 mm Hg or <130/80 mm Hg in high-risk patients; (8) HBPM is useful in the elderly, in whom both BP variability and the white-coat effect are increased; (9) HBPM is of value in patients with diabetes, in whom tight BP control is of paramount importance; (10) Other populations in whom HBPM may be beneficial include pregnant women, children, and patients with kidney disease; and (11) HBPM has the potential to improve the quality of care while reducing costs and should be reimbursed.Call to action on use and reimbursement for home blood pressure monitoring: Executive summary: A joint scientific statement from the american heart association, american society of hypertension, and preventive cardiovascular nurses association
AbstractPickering, T. G., Miller, N. H., Ogedegbe, G., Krakoff, L. R., Artinian, N. T., & Goff, D. (n.d.).Publication year
2008Journal title
HypertensionVolume
52Issue
1Page(s)
1-9AbstractHome blood pressure monitoring (HBPM) overcomes many of the limitations of traditional office blood pressure (BP) measurement and is both cheaper and easier to perform than ambulatory BP monitoring. Monitors that use the oscillometric method are currently available that are accurate, reliable, easy to use, and relatively inexpensive. An increasing number of patients are using them regularly to check their BP at home, but although this has been endorsed by national and international guidelines, detailed recommendations for their use have been lacking. There is a rapidly growing literature showing that measurements taken by patients at home are often lower than readings taken in the office and closer to the average BP recorded by 24-hour ambulatory monitors, which is the BP that best predicts cardiovascular risk. Because of the larger numbers of readings that can be taken by HBPM than in the office and the elimination of the white-coat effect (the increase of BP during an office visit), home readings are more reproducible than office readings and show better correlations with measures of target organ damage. In addition, prospective studies that have used multiple home readings to express the true BP have found that home BP predicts risk better than office BP (class IIa; level of evidence A). This call-to-action article makes the following recommendations: (1) It is recommended that HBPM should become a routine component of BP measurement in the majority of patients with known or suspected hypertension; (2) Patients should be advised to purchase oscillometric monitors that measure BP on the upper arm with an appropriate cuff size and that have been shown to be accurate according to standard international protocols. They should be shown how to use them by their healthcare providers; (3) Two to 3 readings should be taken while the subject is resting in the seated position, both in the morning and at night, over a period of 1 week. A total of ≥ 12 readings are recommended for making clinical decisions; (4) HBPM is indicated in patients with newly diagnosed or suspected hypertension, in whom it may distinguish between white-coat and sustained hypertension. If the results are equivocal, ambulatory BP monitoring may help to establish the diagnosis; (5) In patients with prehypertension, HBPM may be useful for detecting masked hypertension; (6) HBPM is recommended for evaluating the response to any type of antihypertensive treatment and may improve adherence; (7) The target HBPM goal for treatment is <135/85 mm Hg or <130/80 mm Hg in high-risk patients; (8) HBPM is useful in the elderly, in whom both BP variability and the white-coat effect are increased; (9) HBPM is of value in patients with diabetes, in whom tight BP control is of paramount importance; (10) Other populations in whom HBPM may be beneficial include pregnant women, children, and patients with kidney disease; and (11) HBPM has the potential to improve the quality of care while reducing costs and should be reimbursed.Cardiovascular prognosis of sustained and white-coat hypertension in patients with type 2 diabetes mellitus
AbstractEguchi, K., Hoshide, S., Ishikawa, J., Ishikawa, S., Pickering, T. G., Gerin, W., Ogedegbe, G., Schwartz, J. E., Shimada, K., & Kario, K. (n.d.).Publication year
2008Journal title
Blood Pressure MonitoringVolume
13Issue
1Page(s)
15-20AbstractOBJECTIVE: Cardiovascular prognosis in diabetic white-coat hypertension (WCH) has not yet been described. We designed this study to investigate the impact of WCH on cardiovascular events in patients with type 2 diabetes, compared with those having type 2 diabetes along with sustained hypertension (SH), and with nondiabetic hypertensive individuals. METHODS: We performed ambulatory blood pressure (BP) monitoring in 1207 consecutive hypertensive patients at baseline, and they were followed up for 49±22 months. The mean age was 70.7±9.8 years; 262 had type 2 diabetes; and 945 did not. They were classified as having SH with diabetes (n=210); diabetic WCH (n=52); SH alone (n=719); or WCH alone (n=226), using awake BP of 135/85 mmHg as the cutoff value. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals of the risk for cardiovascular events, after controlling for age, sex, body mass index, current smoking, serum creatinine, and clinical systolic BP. RESULTS: During the follow-up period, 97 cardiovascular events occurred. The incidence of cardiovascular events in the diabetic SH group was significantly higher than in the diabetic WCH, nondiabetic SH, and nondiabetic WCH (P<0.05; log-rank test) groups. In Cox regression analysis, the diabetic SH group had significantly higher risk of cardiovascular events compared with the diabetic WCH group (HR: 8.2; 95% confidence intervals: 1.09-61.8; P=0.04). Although nonsignificant, the HRs in the SH and WCH groups, relative to diabetic WCH, exceeded 3.0. CONCLUSIONS: The cardiovascular prognosis for diabetic WCH was better than that for diabetic SH during 4 years of follow-up.Changing health behaviors to improve health outcomes after angioplasty: A randomized trial of net present value versus future value risk communication
AbstractCharlson, M. E., Peterson, J. C., Boutin-Foster, C., Briggs, W. M., Ogedegbe, G. G., McCulloch, C. E., Hollenberg, J., Wong, C., & Allegrante, J. P. (n.d.).Publication year
2008Journal title
Health Education ResearchVolume
23Issue
5Page(s)
826-839AbstractPatients who have undergone angioplasty experience difficulty modifying at-risk behaviors for subsequent cardiac events. The purpose of this study was to test whether an innovative approach to framing of risk, based on 'net present value' economic theory, would be more effective in behavioral intervention than the standard 'future value approach' in reducing cardiovascular morbidity and mortality following angioplasty. At baseline, all patients completed a health assessment, recieved an individualized risk profile and selected risk factors for modification. The intervention randomized patients into two varying methods for illustrating positive effects of behavior change. For the experimental group, each selected risk factor was assigned a numeric biologic age (the net present value) that approximated the relative potential to improve current health status and quality of life when modifying that risk factor. In the control group, risk reduction was framed as the value of preventing future health problems. Ninety-four percent of patients completed 2-year follow-up. There was no difference between the rates of death, stroke, myocardial infarction, Class II-IV angina or severe ischemia (on non-invasive testing) between the net present value group and the future value group. Our results show that a net present risk communication intervention did not result in significant differences in health outcomes.Multiple health-risk behavior in a chronic disease population: What behaviors do people choose to change?
AbstractAllegrante, J. P., Peterson, J. C., Boutin-Foster, C., Ogedegbe, G., & Charlson, M. E. (n.d.).Publication year
2008Journal title
Preventive MedicineVolume
46Issue
3Page(s)
247-251AbstractObjective.: To determine what health behaviors patients choose to change in response to medical advice when they are given the potential net-present value (reduction in biological age) of modifying a behavior. Methods.: Baseline data for multiple health-risk behaviors that were recommended for change among 660 coronary angioplasty patients at the New York-Presbyterian Hospital-Weill-Cornell Medical Center who were enrolled during 2000-02 in one of two arms of a behavioral intervention trial designed to compare different approaches to communicating health risk (net-present vs. future value) were analyzed using multivariate statistical methods. Results.: Although there was no difference between study arms, knowing the biological-age value of behaviors, stage of change, and the total number of behaviors recommended for change was associated with choosing several behaviors. Notably, stage of change was associated in both groups with strength training (intervention OR 2.82, 95% CI 1.85, 4.30; comparison OR 2.84, 95% CI 1.83, 4.43, p < .0001) and reducing weight (intervention OR 2.49, 95% CI 1.32, 4.67, p = .005; comparison OR 1.98, 95% CI 1.80, 3.31, p = .01). Conclusion.: Patients with coronary disease are more likely to choose strength training and reducing weight regardless of knowing the biological-age reduction of any given behavior.Patients' perceptions of electronic monitoring devices affect medication adherence in hypertensive African Americans
AbstractSchoenthaler, A., & Ogedegbe, O. (n.d.).Publication year
2008Journal title
Annals of PharmacotherapyVolume
42Issue
5Page(s)
647-652AbstractBACKGROUND: Electronic monitoring devices (EMDs) are regarded as the gold standard for assessing medication adherence in clinical research. However, little is known about the effect of patients' acceptance of EMDs on medication adherence in African Americans with hypertension who are followed in primary care practices OBJECTIVE: To assess patients' perceptions of EMDs, their acceptance of EMDs, and the relationship of these perceptions to medication adherence in African Americans with hypertension who are followed in community-based practices. METHODS: Patients were recruited from a larger randomized controlled trial assessing the effect of motivational interviewing on medication adherence and blood pressure in hypertensive African American patients followed in 2 New York City primary care practices. Medication adherence was assessed with a Medication Event Monitoring System (MEMS) during a 12-month monitoring period. At the 12-month follow-up, patients' perceptions of the MEMS were assessed with a 17-item questionnaire. ANOVA was used to compare patients' responses (agree, neither, disagree) with the MEMS adherence over the monitoring period. Tukey's post hoc tests were used to determine whether there were significant differences among the 3 groups. RESULTS: Participants were predominantly women, low-income, unemployed, had a high school education, and were a mean age of 53 years. Approximately two-thirds of the participants stated that the MEMS helped them remember to take their medications, 93% reported that the MEMS was easy to open, 85% did not find it stressful, and 75% liked the MEMS and used it everyday. One-third of patients preferred using a pillbox and 25% did not like traveling with the MEMS. Patients who stated that they used the MEMS every day, felt comfortable using it in front of others, and remembered to put refills in the MEMS had significantly better adherence over the study period than did those who disagreed (p ≤ 0.05). CONCLUSIONS: African American patients treated for hypertension in community-based practices held positive perceptions about a MEMS. Perceptions about the practicality of a MEMS may yield important information about actual medication-taking behavior.Psychosocial mediators of the relationship between race/ethnicity and depressive symptoms in latino and white patients with coronary artery disease
AbstractBoutin-Foster, C., Ogedegbe, G., Peterson, J., Briggs, W. M., Allegrante, J. P., & Charlson, M. E. (n.d.).Publication year
2008Journal title
Journal of the National Medical AssociationVolume
100Issue
7Page(s)
849-855AbstractBackground: The high prevalence of depressive symptoms in patients with coronary artery disease has been well documented. However, little is known about the prevalence and correlates of depressive symptoms in Latino patients with coronary artery disease. Purpose: Among Latino and white patients who had percutaneous transluminal coronary angioplasty (PTCA), this study examined whether differences in the prevalence of depressive symptoms exist and the degree to which psychosocial factors (years of education, employment status, stressful life events, emotional social support) explained any differences. Methods: Using a cross-sectional design, closed-format questionnaires were used to obtain clinical and psychosocial history. The definition of high depressive symptoms was based on a score of ≥16 on the Center for Epidemiologic Studies Depression Scale (CES-D). Results: Compared to whites (n=492), Latinos (n=59) were younger, and a greater proportion were female, but fewer completed high school and fewer were employed (P<0.05). More Latinos reported experiencing ≥2 recent stressful life events, but fewer reported having emotional social support (P<0.05). There was a significant association between race/ethnicity and depressive symptoms (OR=2.3, 95% CI: 1.3-4.5). In multivariate analyses, the significance of this association diminished when psychosocial variables were added to the model. Conclusions: In this study, education, employment, stressful life events and emotional social support partially explained the observed racial/ethnic differences in depressive symptoms.Revision and validation of the medication adherence self-efficacy scale (MASES) in hypertensive African Americans
AbstractFernandez, S., Chaplin, W., Schoenthaler, A. M., & Ogedegbe, G. (n.d.).Publication year
2008Journal title
Journal of Behavioral MedicineVolume
31Issue
6Page(s)
453-462AbstractStudy purpose was to revise and examine the validity of the Medication Adherence Self-Efficacy Scale (MASES) in an independent sample of 168 hypertensive African Americans: mean age 54 years (SD = 12.36); 86% female; 76% high school education or greater. Participants provided demographic information; completed the MASES, self-report and electronic measures of medication adherence at baseline and three months. Confirmatory (CFA), exploratory (EFA) factor analyses, and classical test theory (CTT) analyses suggested that MASES is unidimensional and internally reliable. Item response theory (IRT) analyses led to a revised 13-item version of the scale: MASES-R. EFA, CTT, and IRT results provide a foundation of support for MASES-R reliability and validity for African Americans with hypertension. Research examining MASES-R psychometric properties in other ethnic groups will improve generalizability of findings and utility of the scale across groups. The MASES-R is brief, quick to administer, and can capture useful data on adherence self-efficacy.The Epidemiology of Hypertension
Ogedegbe, O., & Pickering, T. G. (n.d.). In Hurst’s the Heart (8th eds., 1–).Publication year
2008Page(s)
1551 - 1570The misdiagnosis of hypertension: The role of patient anxiety
AbstractOgedegbe, G., Pickering, T. G., Clemow, L., Chaplin, W., Spruill, T. M., Albanese, G. M., Eguchi, K., Burg, M., & Gerin, W. (n.d.).Publication year
2008Journal title
Archives of Internal MedicineVolume
168Issue
22Page(s)
2459-2465AbstractBackground: The white coat effect (defined as the difference between blood pressure [BP] measurements taken at the physician's office and those taken outside the office) is an important determinant of misdiagnosis of hypertension, but little is known about the mechanisms underlying this phenomenon. We tested the hypothesis that the white coat effect may be a conditioned response as opposed to a manifestation of general anxiety. Methods: A total of 238 patients in a hypertension clinic wore ambulatory blood pressure monitors on 3 separate days 1 month apart. At each clinic visit, BP readings were manually triggered in the waiting area and the examination room (in the presence and absence of the physician) and were compared with the mercury sphygmomanometer readings taken by the physician in the examination room. Patients completed trait and state anxiety measures before and after each BP assessment. Results: A total of 35% of the sample was normotensive, and 9%, 37%, and 19% had white coat, sustained, and masked hypertension, respectively. The diagnostic category was associated with the state anxiety measure (F3,237 = 6.4, P < .001) but not with the trait anxiety measure. Patients with white coat hypertension had significantly higher state anxiety scores (t = 2.67, P < .01), with the greatest difference reported during the physician measurement. The same pattern was observed for BP changes, which generally paralleled the changes in state anxiety (t = 4.86, P < .002 for systolic BP; t = 3.51, P < .002 for diastolic BP). Conclusions: These findings support our hypothesis that the white coat effect is a conditioned response. The BP measurements taken by physicians appear to exacerbate the white coat effect more than other means. This problem could be addressed with uniform use of automated BP devices in office settings.The relative risk of cardiovascular death among racial and ethnic minorities with metabolic syndrome: Data from the NHANES-II mortality follow-up
AbstractMartins, D., Tareen, N., Ogedegbe, G., Pan, D., & Norris, K. (n.d.).Publication year
2008Journal title
Journal of the National Medical AssociationVolume
100Issue
5Page(s)
565-571AbstractThe tendency for selected cardiovascular disease (CVD) risk factors to occur in clusters has led to the description of metabolic syndrome (MetS). The relative impact of the individual risk factor on the overall relative risk (RR) for cardiovascular death from metabolic syndrome is not well established and may differ across the different racial/ethnic groups. Using data from the National Health and Nutrition Examination Survey (NHANES II) mortality follow-up (NH2MS), we determined the prevalence and RR of cardiovascular death for individual components in the overall population and across racial and ethnic groups. The prevalence of MetS components varied significantly across gender and racial/ethnic groupings. The RR for CVD also varies for the number and different components of MetS. The adjusted RR for cardiovascular death was highest with diabetes (3.23; 95% CI: 2.70-3.88), elevated blood pressure (2.28; 95% CI: 1.94-2.67) and high triglycerides (1.63; 95% CI: 1.34-2.00). Although the RR for cardiovascular death differs significantly for some of the different components, the overall findings were similar across racial/ethnic groups. The two components that confer the highest risks for death are more prevalent in African Americans. We concluded that the RR of cardiovascular death associated with the diagnosis of MetS varies depending on the number and components used to establish the diagnosis of MetS and the racial/ethnic characteristic of the participants.Understanding the nature and role of spirituality in relation to medication adherence: A proposed conceptual model
AbstractLewis, L. M., & Ogedegbe, G. (n.d.).Publication year
2008Journal title
Holistic Nursing PracticeVolume
22Issue
5Page(s)
261-267AbstractRacial disparities in hypertension prevalence and its attendant complications are well documented. Spirituality is an important component of African American beliefs and a small body of literature suggests that spirituality influences hypertension management in African Americans. This article describes a conceptual model of spirituality that may be useful for developing interventions for increasing medication adherence and decreasing blood pressure in African Americans diagnosed with hypertension.African American Spirituality: A Process of Honoring God, Others, and Self
AbstractLewis, L. M., Hankin, S., Reynolds, D., & Ogedegbe, G. (n.d.).Publication year
2007Journal title
Journal of Holistic NursingVolume
25Issue
1Page(s)
16-23AbstractPurpose: The purpose of this pilot study was to explore African American definitions of practicing spirituality and to describe the process of spirituality and its relationship to health promotion. Method: Data were collected using semi-structured interview questions via two focus groups from a total of 12 participants who self-identified as African American. Findings: This grounded theory methodology generated three categories of spirituality: (a) love in action, (b) relationships and connections, and (c) unconditional love. The overall process of practicing spirituality and its relationship to health identified a process of honoring God, self, and others. Conclusion: Research studies that investigate the concept of spirituality and its relationship to health promotion and disease management need to address the subjective experience of spirituality based on participant definitions rather than researcher-focused definitions of spirituality.An RCT of the effect of motivational interviewing on medication adherence in hypertensive African Americans: Rationale and design
AbstractOgedegbe, G., Schoenthaler, A., Richardson, T., Lewis, L., Belue, R., Espinosa, E., Spencer, J., Allegrante, J. P., & Charlson, M. E. (n.d.).Publication year
2007Journal title
Contemporary Clinical TrialsVolume
28Issue
2Page(s)
169-181AbstractBackground: Hypertension disproportionately affects African Americans compared to whites, and it is the single most common explanation for the disparity in mortality between African Americans and whites. Adherence with antihypertensive medications can help reduce risk of negative hypertension-related outcomes. Motivational interviewing is a promising patient-centered approach for improving adherence in patients with chronic diseases. In this paper we describe the rationale and design of an ongoing randomized controlled trial testing the effectiveness of motivational interviewing versus usual care in improving medication adherence among 190 African American uncontrolled hypertensive patients, who receive care in a primary care setting. Methods: The usual care group receives standard medical care, while those in the intervention group receive standard care plus four sessions of motivational interviewing at 3-month intervals for a period of 1 year. This technique consists of brief, patient-driven counseling sessions to facilitate initiation and maintenance of behavior change. The primary outcome is adherence to prescribed antihypertensive medication, assessed with the electronic medication events monitoring system (MEMS) and the Morisky self-report adherence questionnaire. Secondary outcomes are within-patient changes in blood pressure, self-efficacy, and intrinsic motivation between baseline and 12 months. We report the baseline sociodemographic and clinical characteristics of the participants. Conclusions: Despite the potential utility of motivational interviewing, little is known about its effectiveness in improving medication adherence among hypertensive patients, especially African Americans. In addition to the baseline data this study has generated, this trial should provide data with which we can assess the effectiveness of this approach as a behavioral intervention.Appointment-keeping behavior is not related to medication adherence in hypertensive African Americans
AbstractOgedegbe, G., Schoenthaler, A., & Fernandez, S. (n.d.).Publication year
2007Journal title
Journal of general internal medicineVolume
22Issue
8Page(s)
1176-1179AbstractOBJECTIVE: The relationship between appointment-keeping behavior, medication adherence (ADH), and systolic and diastolic blood pressure (SBP and DBP) was assessed in 153 hypertensive African Americans followed in a community-based practice. OBJECTIVE: ADH was assessed with a self-report questionnaire. BP was obtained from electronic medical records and appointment attendance was determined from the log of all appointments made during the 12-month study period. Nonadherence rates were compared across appointment attendance categories with chi-square. Logistic regression was used to assess the relationship between ADH and appointment attendance, whereas multivariate analysis of covariance (MANCOVA) was used to examine the relationship between appointment attendance and BP. RESULTS: Twenty-five percent of patients (87% women, mean age 52 years) did not miss any appointments, 44% missed 1-30%, and 31% missed greater than 30%. Adjusted nonadherence rates were similar for all 3 categories (70%, 66%, and 65%, respectively, p = 0.88) as were adjusted mean SBP and DBP in the MANCOVA model, [F (4, 218) = 1.13, p = .34]. Logistic regression analysis did not indicate a significant relationship between appointment attendance and ADH. CONCLUSIONS: Appointment-keeping behavior was not related to ADH or BP among hypertensive African Americans. It should not be used as a proxy for ADH in this patient population.Ascribing meaning to hypertension: A qualitative study among African Americans with uncontrolled hypertension
AbstractBoutin-Foster, C., Ogedegbe, G., Ravenell, J. E., Robbins, L., & Charlson, M. E. (n.d.).Publication year
2007Journal title
Ethnicity and DiseaseVolume
17Issue
1Page(s)
29-34AbstractObjective: The objective was to elicit patients' perceptions regarding the meaning of hypertension and to identify the personal, social, and environmental factors that might influence their perceptions. Design: Qualitative study. Setting: Adult ambulatory care practice. Participants: African American patients with uncontrolled hypertension. Intervention/Methods: In-depth structured interviews were conducted with a purposive sample of 60 patients. Interviews were audio-taped, transcribed verbatim, and analyzed by using grounded theory. Results: Patient descriptions of hypertension were grouped into three categories: 1) their thoughts on hypertension; 2) the consequences of hypertension; and 3) the impact that having hypertension had on their lifestyle. Factors that might have shaped how patients described hypertension were grouped into three categories: 1) the experiences of their social networks such as family and friends; 2) their personal experiences; and 3) information about hypertension that they might have gathered from the medical literature or during an encounter with a healthcare provider. Patients with family members who had experienced hypertension-related complications such as stroke were more likely to view hypertension as a serious condition. Patients who themselves experienced hypertension-related symptoms and who also had family members with a history of hypertensive disease were more likely to describe a willingness to make lifestyle changes. Conclusions: In this study, personal experiences, experiences of family and friends, and encounters with the healthcare environment influenced patients' perceptions of hypertension and their willingness to make lifestyle changes. These findings can be used as a framework for helping to tailor effective and culture-specific interventions.Perspectives on Mechanisms of Racial Disparities in Hypertension
Ogedegbe, O. (n.d.). In From Health Inequity to Equity in Health: A New Global Approach to Health Disparities (1–).Publication year
2007