• Research in Community and Public Health Nursing
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• v.23 no.2
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• pp.189-200
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• 2012

Purpose: The purpose of this study is to identify factors associated with the stages of change in medication adherence in patients with hypertension. Methods: Participants were 323 patients with hypertension. Sociodemographic/medication-related characteristics, stages of change, processes of change, self efficacy and decisional balance were self-administered. Results: Stages of change were significantly different according to gender, age, job and living arrangement. A multinominal logistic regression analysis has revealed that gender, age, living arrangement, self-liberation, and self-efficacy were significantly associated with the precontemplation stage. Age and self-liberation were significantly associated with the contemplation stage. Gender, age, living arrangement, and self-liberation were significantly associated with the preparation stage. Gender and helping relationship were significantly associated with the action stage. This model explained 52.0% of the stages of change in medication adherence. Conclusion: The tailored intervention strategies based on the stages of change may be needed for improving medication adherence in patients with hypertension.

• Proceedings of the Korean Biophysical Society Conference
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• 1999.06a
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• pp.61-62
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• 1999

;The mechanisms inducing hypertension are actively investigated and are still challenging topics. Basically hypertension must be caused by the disorder of $Ca^{2+}$ metabolism in vascular smooth muscle, such as the increase of $Ca^{2+}$ influx, the decrease of ci+ efflux, or the change of sensitivity of contractile protein etc. The one of cause of the increase of ci+ influx may be the change of ci+ channel activity. Even though the relationships of ci+ channel activity and hypertension were studied using various hypertension models, still it is not clear how much change of $Ca^{2+}$ channel activity in diabetes mellitus (DM) induced hypertension is occurred. We induced DM hypertension in SD rat and compared the $Ca^{2+}$ channel activity with age-matched normotensive SD rat. For inducing DM hypertension, left kidney was removed with 200 gm rat and, after 1 month, 60 mg/kg of streptozotocin was injected into peritoneal space to induce diabetes mellitus. Usually after 4-6 weeks, hypertension was fully induced. For isolating vascular smooth muscle cells (VSMC), we used mesenteric arteriole (3rd - 4th branch of mesenteric artery) of which diameter is below 150 urn. VSMCs were isolated enzymatically. $Ca^{2+}$ current was measured using whole cell patch clamp technique. All experiments were performed at $37^{\circ}C$. The cell membrane area of VSMC of DM hypertensive rat is larger than that of control VSMC($36.6{\pm}3.64{\;}pF{\;}vs{\;}22.4{\pm}1.29{\;}pF, {\;}mean{\pm}S.E.$) When we compared the current amplitude, the $Ca^{2+}$ current amplitude in VSMC of DM hypertensive rat is much larger than that in VSMC of normotensive age-matched rat. After $Ca^{2+}$ current amplitude was normalized by cell membrane area, the current amplitude in DM hypertension is increased to $249.1{\pm}15.9{\;}%{\;}(mean{\pm}S.E.M)$, which means the ;absolute current amplitude is about 4 times larger in DM hypertension. When we compared the steady state activation and inactivation. there were no noticeable differences. From these results. one of cause of the DM hypertension is due to the increase of $Ca^{2+}$ current amplitude. But it need further study why the $Ca^{2+}$ current is so large in VSMC of DM hypertension and how much $Ca^{2+}$ influx through $Ca^{2+}$ channel contribute to the increase of intracellular $Ca^{2+}$ and eventually contribute to development of hypertension.ypertension.

• Journal of Preventive Medicine and Public Health
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• v.21 no.1 s.23
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• pp.47-60
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• 1988

The monthly ambulatory treatment days in newly detected hypertension group and known hypertension group were analyzed. The population was identified through the records of screening examination given by Korea Medical Insurance Corporation during the period from April to July, 1986. From the records of screening examination, 11,614 hypertensive patients were identified. By random sampling,959 patients were selected : among them, 544 fell under the category of known hypertension group and the other 415 fell under the newly detected hypertension group. The monthly ambulatory treatment days of these patients during the period from the April, 1985 to September, 1987 were analyzed in order to compare the exents of medical care utilization as well as to define and analyze the determinants responsible for the ambulatory treatment days between the two groups. The following results were obtained. 1) In the known hypertension group, no statistically significant changes in the ambulatory treatment days was observed after, in comparision to before, the screening examination. However, in the newly detected hypertension group the medical care utilization increased after the screening examination because of hypertension. 2) The ambulatory treatment days for hypertension of the known hypertension was statistically significant and higher than that of the newly detected hypertension group after screening examination. 3) There was no statistically significant change in the ambulatory treatment days in association with diseases other than hypertension in either group before and after the screening examination. 4) There was no statistically significant variable responsible for ambulatory treatment days in the known hypertension group. However, the income was a statistically significant variable in the newly detected hypertension group. 5) After the screening examination, the variables determining the ambulatory treatment days were the age of the patient and the diastolic blood pressure in the known hypertension group. These variables responsible for 2.02% of the total ambulatory treatment days. In the newly detected hypertension group, the income was a statistically significant variable which was responsible for 2.10% of total ambulatory treatment days. The above results satisfied the hypothesis that there would be no significant changes in the ambulatory treatment days before and after the screening examination in the known hypertension group. Also the hypothesis that there would be no significant change in the exents of medical care utilization for the diseases other than hypertension before and after the screening examination in either group was satisfied Also the medical care utilization was significantly higher in the known hypertension group than the newly detected hypertension group after the screening examination. This finding satisfied the hypothesis. This study was limited by the lack of considering fully the variables reponsible for the clinical symptoms of hypertension as well as for the individual characteristics. Thus, the result of this study are not fully adequate to define the determinants responsible for the exents of medical care utilization. In the future studies on medical rare utilization, additional variables should be considered.

• Journal of Korean Public Health Nursing
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• v.30 no.1
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• pp.105-121
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• 2016

Purpose: This study examined the influencing factors from the Transtheoretical Model on the stage of change in the self-management behaviors, i.e. regular physical activity and diet, among community-residing adults with hypertension in a rural area. Methods: With a cross-sectional descriptive design, 134 adults who had registered and received a prescription for hypertension medication from a public health center in W city were recruited using convenient sampling. The instrument was an interviewer-administered questionnaire on the stage of change, process of change, self-efficacy, and decisional balance of physical activity and diet. The data were analyzed using descriptive statistics, 2-sample t-test, ${\chi}^2$ test, and logistic regression. Results: The results revealed significant differences in the process of change, self-efficacy, and decisional balance of physical activity and diet between those who were in the pre-execution stage (precontemplation, contemplation, preparation) and those who were in the execution stage (action and maintenance). Logistic regression showed that consciousness raising and self-efficacy were significant predictors of the execution stage in physical activity, and self-reevaluation, social liberation and self-efficacy were significant predictors in the diet. Conclusion: The relevant processes of change, differentiated according to the stage of change, along with self-efficacy, should be addressed to enhance the execution of self-management behaviors among hypertensive adults residing in the community.

• The Journal of the Korean life insurance medical association
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• v.30 no.1
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• pp.21-23
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• 2011

Chronic thromboembolic pulmonary hypertension(CTEPH) is known as class IV pulmonary hypertension. Unlike other subtype of pulmonary hypertension, surgical treatment such as pulmonary endarterectomy is well known therapeutic strategy. Also there's oral disease-modifying drug which is developed lately. According to recent article, the prognosis of CTEPH is markedly improved. If prognosis of certain disease is improved, insurance rating should be altered. Whether rating change is necessary or not, mortality analysis of CTEPH was performed from recently published source article, Estimated extra-risks are MR of 525% and EDR of 37‰. In conclusion, the extra-risks of CTEPH are still very high.

• The Journal of the Korea Contents Association
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• v.11 no.12
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• pp.364-377
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• 2011

This study was done to evaluate the effects of a transtheoretical model (TTM) based exercise behavior improving program for older adults with hypertension on the stage of change, processes of change, decisional balance, exercise self-efficacy, blood pressure and physical activity. A non-equivalent control pre-post design was used for this study. The subjects were 41 adults over 65 years of age with hypertension who did not practice regular exercise. The experimental group (n=20) received the 8-week TTM based exercise behavior improving program. The control group received hypertension self care management education. Descriptive analysis, $x^2$-test, t-test, paired t-test were used for analyzing the data using SPSS for Windows 14.0. As a results, there was a significant increase in stage of change, total score for processes of change, behavioral process of change, exercise self-efficacy, total physical activity, and walking in the experimental group compared to the control group. But, there were no significant differences between the two groups on the experiential processes of change, decisional balance, and blood pressure. The results of this study suggest that a TTM based exercise behavior improving program has positive effects on improving exercise behavior among older adults with hypertension.

• The Korean Journal of Nuclear Medicine
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• v.10 no.1
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• pp.1-14
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• 1976

The etiologic role of renin-angiotensin system and sodium-volume status in the pathophysiology of various forms of hypertension was investigated. Plasma renin activity (PRA) was measured by radioimmunoassay, while sodium-volume status was evaluated by the determination of total exchangeable sodium(NaE) using isotope dilution method. The subjects consisted of 25 controls, 24 patients with essential hypertension, with chronic renal failure (13 with hypertension, 9 without hypertension) and with malignant hypertension. The results were as follows: 1. An inverse correlation between NaE and PRA was noted in control subjects (r=-0.598, p<0.001) and normal renin essential hypertension(r=-0.551, p<0.05) and the chronic renal failure with hypertension. (r=-0.790, p<0.001) 2. NaE increased markedly the in chronic renal failure with hypertension ($66.9{\pm}8.69mEq/kg$ of LBM, p<0.001) and the chronic renal failure without hypertension ($54.9{\pm}9.28mEq/kg$ of LBM, p<0.05), while mild increase was noted in malignant hypertension ($51.7{\pm}6.24mEq/kg$ of LBM, 0.05$50.1{\pm}7.24mEq$) as well as in its renin subgroups.(p>0.1) 3. Absolute value of PRA was not deviated significantly from control group ($2.53{\pm}1.416ng/ml/hr$) except in malignant hypertension ($6.09{\pm}2.042$, p<0.001). But PRA was inappropriately high in relation to prevailing NaE in the chronic renal failure with hypertension (eleven of thirteen patients) and malignant hypertension (ten of fourteen patients), while PRA variatiation was within physiologic range in the chronic renal failure without hypertension. 4. The NaE-PRA product was markedly increased in the chronic renal failure with hypertension ($514.4{\pm}42.10$, p<0.001) and in malignant hypertension ($442.7{\pm}55.03$, p<0.001), while moderately increased NaE-PRA product was noted in the chronic renal failure without hypertension ($402.6{\pm}59.67$, p<0.001). No significant difference in NaE-PRA product was noted in essential hypertension ($354.4{\pm}62.38$, p>0.1). It is suggested that renin-angiotensin system plays a predominant role in the pathogenesis of malignant hypertension and in hypertension of chronic renal failure, though sodium retention is also contributing factor. PRA variation in essential hypertension does not appear to be associated with any consistent change in Na-volume status, suggesting the existence of another mechanism in the genesis of hypertension and PRA variation.

• Journal of Korean Academy of Rural Health Nursing
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• v.1 no.1
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• pp.59-64
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• 2006

Purpose: This study was done to identify the effect of a group walking exercise program on weight, obesity, blood pressure and cholesterol in elderly patients with hypertension. Method: From the population of elderly people in Hwasung city, 80 people with hypertension were selected as participants in this study. Frequencies and paired t-test were used to analyze the data. Results: The group walking exercise program lowered weight, obesity, blood pressure, and cholesterol. And such a change appeared to be effective statistically. Conclusion: Therefore, it is important to develop a program and environment that promotes group walking exercise in elderly patients with hypertension.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.245-252
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• 1990

To see the change of pulmonary arterial pressure after mitral valve replacement, postoperative cardiac catheterization and echocardiographies were performed in 12 patients of mitral valvular disease with pulmonary hypertension[systolic pulmonary arterial pressure>50 mm Hg]. The mean follow-up duration was 35.4[range: 15-47] months per patient. The following results were obtained. 1] Preoperative systolic pulmonary arterial pressure value of 66.17\ulcorner10.73mmHg decreased significantly to 29.17\ulcorner6.86mmHg postoperatively[p<0.01]. 2] Preoperative Pp/Ps value of 0.67\ulcorner0.13 decreased significantly to 0.28\ulcorner0.06 postoperatively[p<0.01]. 3] Preoperative PAWP value of 29.00\ulcorner4.02mmHg decreased significantly to 9.92\ulcorner4.27 mmHg postoperatively[p<0.01]. 4] Preoperative LAD value of 5.58\ulcorner1.20cm decreased significantly to 4.37\ulcorner0.67cm postoperatively [p<0.01]. In conclusion, pulmonary arterial hypertension secondary to mitral valvular disease could be reduced to normal range after successful mitral valve replacement.

• Journal of Korean Public Health Nursing
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• v.16 no.2
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• pp.445-453
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• 2002

Purpose: This study has been designed to evaluate occupational health services on workers with hypertension Method: Study participants were 108 workers having a diagnosed hypertension. The instrument used for this study was the questionnaire developed by Cho(1998). Analysis of the data was done with SPSS Win 10.0 for descriptive statistics, Correlation coefficient. Results: 1. The mean score of process domain was $3.77\pm.43$ The score of process domains were usefulness of health management$(3.98\pm.49)$, education or counselling$(3.87\pm.53)$, follow up in medical examination$(3.79\pm.58)$, usefulness of providing materials$(3.53\pm.62)$, perception of medical examination $(3.37\pm.80)$ 2. The mean score of outcome domain was $3.47 \pm.44$ The score of outcome domains were obstructiveness of social life$(3.90\pm.78)$, habits of living $(3.41\pm.76)$, blood pressure change $(3.25\pm.81)$, perception of seriousness$(3.02\pm.88)$. 3. Blood pressure change was significant correlated with education or counselling(r=.31) and usefulness of providing materials(r=.28).