Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Lifestyle Intervention Supported by Mobile Health Technologies to Improve the Cardiometabolic Risk Profile of Individuals at Risk for Cardiovascular Disease and Type 2 Diabetes.
Brief Summary: Cardiovascular diseases are the leading cause of death among Canadians. In those with diabetes, cardiovascular complications are responsible for more than 70% of deaths. While there is much interest in identifying and treating risk factors, the exact biological mechanisms, their measurement and optimal ways to prevent and manage them are poorly understood.

Physical activity and regular exercise can prevent diabetes and effectively manage risk factors, but most Canadians do not exercise enough to beneficially manage risk. Tailored exercise prescribed by a family physician has shown promise as a means to increase fitness and reduce risk, but optimal implementation practices remain unknown - especially in rural and remote communities with reduced access to healthcare. Mobile health technologies have proved to be a beneficial tool to achieve blood pressure and blood glucose control in patients with diabetes. These technologies may address the limited access to health interventions in rural and remote regions. However, the potential as a tool to support exercise-based prevention activities unknown.

Therefore, this study was undertaken to investigate the effects of a tailored exercise prescription alone or supported by mobile health technologies to improve cardiovascular risk factors in rural community-dwelling adults at risk for cardiovascular disease and type 2 diabetes.

Adults with cardiovascular risk factors were recruited from rural communities and randomized to either: 1) an intervention group receiving an exercise prescription and devices for monitoring of risk factors with a smartphone data portal equipped with a mobile health application; or 2) an active control group receiving only an exercise prescription.

It was hypothesized that the intervention group would reduce their risk to a greater extent than the active control group following 12 weeks, and that these improvements would be better maintained in the intervention group at 24 and 52 weeks compared to the active control group.


Options:
A: Inclusion Criteria:

* Adults \> 18 years
* Diagnosed with stroke at least one month ago on neuroimaging (CT or MRI)
* Taking more than one drug for risk factor control
* Possessing a personal mobile phone
* Modified Rankin scores \<3 (to exclude severely disabled persons)
* Able to operate sms
* Do not intend to travel outside the country in the next 2 months (because the followup period is 2 months and during this period mobile communication through sms is required)
* Give informed consent

Exclusion Criteria:

* Chronic Renal Failure (because such patients keep getting admitted often and also have several contraindications for therapy)

  * Any known malignancy
  * Enrolled in another study
B: Inclusion Criteria:

* Clinical diagnosis of hypertension and are either currently receiving or are about to start blood pressure lowering medication
* Mean blood pressure at enrolment is \< 175/105
* Aged 21 years or older
* Must have access to a cell-phone (shared access is allowed if access is daily and the phone owner agrees to participate)
* Must be able to use SMS-text (help by a partner is allowed for illiterate subjects, subjects with poor vision, or subjects who are learning disabled)
* Must be resident in the study area and must be expected to be resident for the duration of the study

Exclusion Criteria:

* Another member of the household has already been recruited into the trial
* If female, they are not pregnant or within three months post-partum by self-report
* They are not willing to give informed consent and take part in the study.
C: Inclusion Criteria:

* self-identify as African American/Black
* be \>18 years
* have a diagnosis of HBP based on ICD-9 codes
* have uncontrolled hypertension on two successive clinic visits prior to screening (clinic SBP \> 140 mm Hg, DBP \> 90 mm Hg or SBP \> 130, DBP \> 80 for those with diabetes or kidney disease) as documented in the medical record
* be taking at least one antihypertensive medication
* own a cell phone capable of receiving and sending text messages
* be able to pay for and obtain hypertension medication
* English speaking
* willing to attend two data collection visits in Detroit, MI

Exclusion Criteria:

* receiving hemodialysis
* admits to planning to terminate cell phone contract during the next one month
* compliance risk (i.e., self-reported illicit drug use and/or alcohol abuse as measured by a score of \>2 for CAGE questions
* health literacy less than third grade reading level
* other major health problems (e.g., terminal stage of cancer, advanced liver disease)
D: Inclusion Criteria:

* aged 18-70 years
* two or more metabolic syndrome risk factors according to National Cholesterol Education Program Adult Treatment Panel III criteria: waist circumference ≥ 88 cm (women) or ≥ 102 cm (men); systolic blood pressure ≥ 135 mmHg and/or diastolic blood pressure ≥ 85 mmHg; fasting plasma glucose ≥ 6.1 mmol/L; triglycerides ≥ 1.7 mmol/L; and high density lipoprotein cholesterol ≤ 1.29 mmol/L (women) or ≤ 1.02 mmol/L (men)

Exclusion Criteria:

* systolic blood pressure \> 180 mmHg and/or diastolic blood pressure \> 110mmHg
* type 1 diabetes
* history of myocardial infarction, angioplasty, coronary artery bypass or cerebrovascular ischemia/stroke
* symptomatic congestive heart failure
* atrial flutter
* unstable angina
* unstable pulmonary disease
* use of medications known to affect heart rate
* second or third degree heart block
* history of alcoholism, drug abuse or other emotional cognitive or psychiatric problems
* pacemaker
* unstable metabolic disease and orthopedic or rheumatologic problems that could impair the ability to exercise

Answer: D