The purpose of this study is to show that, before registration of chronic degenerative diseases and enforcing management system in health centers, the management of hypertension could achieved comprehensively and continuously by knowing the realities of drug-taking and its related factors those who are being cared for in health centers. For one year, a questionnaire about drug-taking realities of hypertensive patient was distributed at 8 health centers in Taegu from March 24. 1997 to April 24. 1997. The questionnaires were then collected and analysed. The results are as follows: Of 691 patients, 77.4% of patient were taking medicine regularly every day. The reasons why patients weren't taking medicine every day was as follows: the blood pressure became normal(34%, the highest of the group), patients forgot(28.2%), it was difficult to buy the medicine(15.4%), there was no effect even though the patient took medicine continuously. The experience of medical treatment outside of health centers was 28.9%. The types and percentages of alternative medicine are herbs (50.5%), health food(24.5%), folk remedy(13.7%). Among them, 44.6% of patients didn't know if the medicine was effective. Medical treatment places excluding health centers was pharmacies(63.5%-the highest rate). In simple analysis, the older one was the more regularly one took the medicine, but there was no statistical relations. Of health activities, patients eating low-salt diet showed that they took the medicine regularly. Nonsmoking patients and those who experienced drug side-effect and those who doubted doctor's prescriptions and instructions showed that they took alternative, excluding modem medicine. Anti-hypertensive drug medication status according to recognition, attitude, experiences of hypertension showed that patients who thought that they should take anti-hypertensive drug during the whole life time took the medicine regularly(82.3%). The reasons for patients turning to alternatives varied. In case of having subjective symptom(34.1%), those who thought they knew the hypertension well(36.6%), they decided to use alternatives. In multiple logistic regression analysis the key statistics were as follows: The older patients, patients who ate low-salt diet, patients who thought that they should take anti-hypertensive drug during the whole life time, all showed that they took medicines regularly. And also patients who experienced drug side-effect, doubted prescriptions and instructions, and patients who had subjective symptoms, patients who thought that he knew the hypertension very well, all showed higher rate of using alternative medicine. In the future, at the health centers, to register and manage hypertension patients effectively, we must educate patients about regular drug-taking, and alternatives without doctor's prescriptions.
The aim of this study was to determine if a low-molecular weight casein hydrolysate has an anti- hypertensive effect in spontaneously hypertensive rats (SHR). Prior to the in vivo experiment, the casein hydrolysate was confirmed to be resistant to gastrointestinal digestion by confirming the retention of its potency as an inhibitor of angiotensin I-concerting enzyme after incubation with pepsin, trypsin, or chymotrypsin. The in vivo anti-hypertensive effect of the hydrolysate was determined by the tail cuff method. Following an oral administration of the hydrolysate solution, the systolic blood pressure (SBP) decreased by 12.9% (-28.9mmHg; P<0.05) at 3 h after the administration at a dose of 500mg/kg body weight. When the hydrolysate was administered as an emulsion with 30% egg yolk, its anti-hypertensive effect was even more greater at the same dose(-30.8mmHg or -15.9%; P<0.01). In a 50-day long-term trial where the casein hydrolysate was administered once a day, the SBP-lowering effect of the hydrolysate was apparent (P<0.05) from day 35 through the end. Moreover, organ weights and plasma glutamate oxaloacetate transaminase and glutamate pyruvate transaminase activities of the administered SHR were not significantly different from those of controls at the end of the long-term trial.
Objectives : We conducted a randomized, double-blinded clinical trial to assess the anti-hypertensive effect of Ginseng and to know the difference of the effect according to it's growing districts md species by 24-hour ambulatory blood pressure measurement (ABPM). Methods : We allocated 96 hypertensive patients enrolled in this trial to Korean ginseng(KG), American ginseng (AG), Chinese ginseng (CG), and Korean red ginseng (KRG) groups by randomization. Each subject was administered 4.5mg/day of encapsulated ginseng for 4 weeks. We assessed anti-hypertensive effect, blood pressure variability using ABPM and toxicity by blood chemistry before and after treatment. We also evaluated changes of symptoms due to hypertension and adverse effect in all groups at the first visit, 2 weeks later and 4 weeks later. Results : Blood pressure after treatments showed significant decrease of systolic blood pressure (sBP) in the CG-group (p<0,05) and diastolic blood pressure (dBP) in the KRG-group (p<0.05). However, there were no significant changes of sBP (or dBP) after treatment in the other groups and no significant difference in changes of BP between before and after treatment among the 4 groups. Blood pressure variability in the CG-group showed significant decrease after treatment but not in the KRG-group. Symptoms such as headache or neck stiffness and heating sensation due to hypertension improved significantly in all groups, especially in the KRG-group. A3l patients had no adverse effect after treatment and there was no liver or kidney toxicity. Conclusions : CG and KRG seem to have anti-hypertensive effects, but there was no significantly different effect depending on growing district and species of Ginseng.
The Journal of Korean Academic Society of Nursing Education
/
v.5
no.1
/
pp.39-57
/
1999
Essential hypertension is a typical chronic disease requiring adequate and continuous management. And many studies supported that self-care was the essential factor to promote the wellbeing. The purpose of this study is to identify and understand the behavior patterns of self-care in hypertensives. As a research method, 35 Q-statements were collected through Individual interviews and review of the related literatures. 21 subjects were interviewed and the data were analyzed by the PC QUANL program with principal component analysis. There were 6 different self-care types classified as follows 1) Type 1 was the self-oriented control type, monitoring the blood pressure and taking the low salt diet. But they didn't take the anti -hypertensive drug and visit the health agency regularly. 2) Type 2 was the stress-control type. Their main activities were meditation to relieve the stress and communication with family. 3) Type 3 was called daily-life control type. This type tried to make their mind comfort and think positively. They also preferred walking and exercise regularly. 4) Type 4 was the medical-oriented control type, taking the anti-hypertensive drug, visiting the medical personnel and following the medical regimens. 5) Type 5 was the medication-oriented type. They only took the anti -hypertensive drug regularly and didn't any other self-care like as monitoring the blood pressure, taking the low salt diet and exercise. 6) Type 6 was called non-medication control type. This type had no medication, but tried to visit the health agency and health personnel. From the above results, it can be concluded that the self-care types were very various and self-care education have to provide individually according to the characteristics of self-care type. Another repeated study can be recommended to improve the nursing intervention the self-care behavior in chronic patient like as diabetics or rheumatoid arthritis.
Spontaneous hypertensive rats (SHR) are an established model of genetic hypertension. Vascular smooth muscle cells (VSMC) from SHR proliferate faster than those of control rats (Wistar-Kyoto rats; WKY). We tested the hypothesis that induction of heme oxygenase (HO)-1 induced by aprotinin inhibits VSMC proliferation through cell cycle arrest in hypertensive rats. Aprotinin treatment inhibited VSMC proliferation in SHR more than in normotensive rats. These inhibitory effects were associated with cell cycle arrest in the G1 phase. Tin protoporphyrin IX (SnPPIX) reversed the anti-proliferative effect of aprotinin in VSMC from SHR. The level of cyclin D was higher in VSMC of SHR than those of WKY. Aprotinin treatment downregulated the cell cycle regulator, cyclin D, but upregulated the cyclin-dependent kinase inhibitor, p21, in VSMC of SHR. Aprotinin induced HO-1 in VSMC of SHR, but not in those of control rats. Furthermore, aprotinin-induced HO-1 inhibited VSMC proliferation of SHR. Consistently, VSMC proliferation in SHR was significantly inhibited by transfection with the HO-1 gene. These results indicate that induction of HO-1 by aprotinin inhibits VSMC proliferation through cell cycle arrest in hypertensive rats.
Objectives: The purpose of this study is to review clinical studies related to the effect of Traditional Chinese Medicine (TCM) on moderate to severe obese patients with hypertension. Methods: Clinical studies from the China National Knowledge Infrastructure (CNKI) were searched by specific keywords and criteria. Total of 7 randomized controlled trials were selected and analyzed. Results: Various evaluation methods were used to see the effect of TCM compared to conventional western medicine. Most of the studies used herbal medicine combined with conventional anti-hypertensive western medicine. The effective rate of anti-hypertension was higher when TCM was added to conventional anti-hypertensive medicine. Traditional medicine treatment showed significant effect on lowering blood pressure and body mass index. Conclusions: Based on the results of the clinical studies from China, TCM can be a valuable option for moderate to severe obese patients with hypertension. Applying Traditional medicine has a significant effect on lowering blood pressure and weight loss. Combining herbal medicine can be worthy of clinical promotion and application for moderate and severe obese patients with hypertension.
Objectives : The study was conducted to evaluate antioxidative, anti-atherosclerotic and anti-hypertensive effects of natural remedies. Alisma Rhizome (AR) has been used for a long time in Asia in folk remedies for treatment of hypertension and stroke and has been used in Korean traditional medicine for the treatment of glycosuria, gonorrhea, hypercholesterolemia, hypertension, and jaundice and its diuretic effect. These pharmacological effects of AR might come from antioxidant properties of phytochemicals in these materials. Methods : In this study, the antioxidant activity of extract from AR was studied with in vitro methods by measuring the antioxidant activity by TEAC, measuring the scavenging effects on reactive oxygen species (ROS) [superoxide anion, hydroxyl radical] and on reactive nitrogen species (RNS) [nitric oxide and peroxynitrite] as well as measuring the inhibitory effect on $Cu^{2+}$ induced human LDL oxidation and on ACE. Results : The AR extracts were found to have a potent scavenging activity, as well as an inhibitory effect on LDL oxidation and on ACE against all of the reactive species tested, with the water extract showing particularly strong antioxidant activities. Conculsions : The AR extracts have antioxidative, anti-atherosclerotic and anti-hypertensive effects in an in vitro system, which can be used for developing pharmaceutical drugs against oxidative stress and atherosclerosis.
This study was conducted in order to investigate the association between hypertension and oxidative stress-related parameters and to evaluate these parameters in subclinical hypertensive patients and normotensive subjects living in Korea. We attempted to determine whether oxidative stress-related parameters would differ between two groups of 227 newly-diagnosed, untreated (systolic blood pressure (BP) ${\geq}$ 130 mmHg and diastolic BP ${\geq}$ 85 mmHg) and 130 normotensive subjects (systolic BP < 120 mmHg and diastolic BP < 80 mmHg). General characteristics of the subjects were collected using a simple questionnaire. From subjects' blood, degree of DNA damage in lymphocytes, the activities of erythrocyte superoxide dismutase, catalase, and glutathione peroxidase, level of plasma total radical-trapping antioxidant potential (TRAP), glutathione, and anti-oxidative vitamins, as well as plasma lipid profiles and conjugated diene (CD) were analyzed. Evaluation of the associations of oxidative stress-related parameters with blood pressure of the subjects was performed using Pearson partial correlation and multivariate logistic regression analysis after adjusting for confounding factors. Several oxidative stress-related parameters were higher in subclinical hypertensive patients than in normotensive subjects. Plasma levels of ${\alpha}$-tocopherol, ${\beta}$-carotene, TRAP, and activity of GSH-px were significantly lower in subclinical hypertensive patients than in normotensive subjects. Increased levels of DNA damage, lipid peroxidation, triglyceride, total cholesterol, and LDL-cholesterol were observed in subclinical hypertensive patients. These results confirm an association between blood pressure and oxidative stress-related parameters and suggest that the pathogenic role of oxidative stress in hypertension might be significant.
Retinal glial responses to hypertensive glaucomatous injury were spatiotemporally surveyed. Retinas as a whole or vertical sections were processed for anti-glial fibrillary acidic protein (GFAP), anti-Iba1, anti-nerve growth factor (NGF), and anti-tumor necrosis factor (TNF)-${\alpha}$ immunohistochemistry for confocal microscopic analyses. The optic nerve head of paired controls was processed for electron microscopy. GFAP positive astrocytes appeared in the nerve fiber layer in the glaucomatous and control retinas, changing from fine protoplasmic to stout fibrous parallel to glaucomatous duration. Iba1 positive microglia appeared in both retinas, and enormous reaction appeared at the latest glaucomatous. M$\ddot{u}$ller reaction detected by GFAP reactivity expanded from the end feet to whole profile following to duration in the glaucomatous. NGF reactivity expended from the end feet to the proximal radial processes of the M$\ddot{u}$ller cells in both retinas according to glaucomatous duration. TNF-${\alpha}$ immunoreactivity in the nerve fiber layer was stronger in both the glaucomatous and controls than in the normal, and exceptionally at the latest glaucomatous was even lower than the normal. The astrocytes in the optic nerve head are interconnected with each other via gap junction. These results demonstrate that astrocyte reaction propagates to the contralateral via physical links, and TNF-${\alpha}$ is correlated with NGF production for neuroprotection in response to hypertensive glaucomatous injury.
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