Tammy Brady, medical director of the hypertension program at Johns Hopkins Children’s Center, discusses her research and clinical efforts regarding pediatric hypertension and cardiovascular health promotion across the life span and blood pressure cuff sizes for accurate measurements. The main theme of her research is exploration of the optimal way to screen for and diagnose hypertension and to treat people with the condition. She also directs the Reversing the Negative Cardiovascular Effects of Weight (ReNEW) Clinic, a multidisciplinary obesity and hypertension facility. During each visit, patients are seen by a pediatric nephrologist, dietitian, physical therapist and behavioral psychologist.
My name is Danny Brady. I am an associate professor of pediatrics in the division of pediatric nephrology with a joint appointment in the Department of Epidemiology at the School of Public Health. I'm the Medical Director of the pediatric hypertension program at the Johns Hopkins Children's Center. I'm also the Vice Chair for Clinical Research in the Department of Pediatrics and the Associate Director of the Welts Center for Prevention Epidemiology and clinical research. My career has really focused on the conduct of rigorous clinical research which is primarily focused on pediatric hypertension and cardiovascular health promotion across the lifespan. My research portfolio spans from secondary data analysis of existing data sets to coding large national quality improvement collaboratives to primary data collection via chart review and via participant recruitment for cross sectional cohort registry studies and clinical trials. The main theme of this research has been exploring the optical way to screen diagnose and treat people for hypertension and to determine interventions that can prevent or treat target organ injury resulting from hypertension. In fact, my clinical and research efforts often intersect I direct a multidisciplinary obesity related hypertension clinic called the Renewed Clinic, which stands for reversing the negative cardiovascular effects of weight. Now, this clinic is my great joy and it was designed to provide a multifaceted approach to the care of Children with comorbid obesity and hypertension by providing evaluation and treatment by me, a pediatric nephrologist, a dietician, a physical therapist and a behavioral psychologist. At each visit, the patients in this clinic are consecutively invited to participate in a prospective longitudinal cohort study which consists of chart review of their clinic visits. This code has contributed to a multitude of publications primarily first authored by Chinese regarding the association of cardiovascular disease risk factors with mood obstructive sleep apnea, diastolic dysfunction and birth history. Just to name a few, we've also explored the accuracy of resting metabolic rate calculations in Children with extreme obesity and each of these studies has informed and enhanced the care of Children. I see I'm also extremely passionate about proper blood pressure measurement. Along with my Wealth Center colleagues, I have led four randomized clinical trials, each of which has tested the impact of various errors in blood pressure measurement technique on blood pressure measurement accuracy. And this work has shown that resting for five minutes prior to measurement is really important for accuracy among patients with stage two or greater hypertension. That individualized cuff selection is essential to accuracy because choosing the wrong cuff can lead to errors as large as 20 millimeters of mercury. That arm position is also key to accurate measurement. And that being in a quiet place for measurement may not be as important as we previously thought. So, Tom, I am a passionate physician scientist who finds immense joy, not only in my cardiovascular disease research, but also in training and mentoring trainees and junior faculty. So I'd like to end this by thanking all of the patients and families who have entrusted their care to me and to thank them for their contribution to furthering the view.