• Title/Summary/Keyword: Hypertensive patient

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A Study on the Automatic Pressure Controller Using Adaptive Control Algorithma (적응 제어 방식을 이용한 혈압자동 조절기에 관한 연구)

  • 이상훈;김영철;민병구
    • 제어로봇시스템학회:학술대회논문집
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    • 1986.10a
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    • pp.648-651
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    • 1986
  • Sometimes, there are conditions when rapid control of the hypertension needed such as malignant hypertension, and the preoperative pereparation of the hypertensive patient requiring emergency operation, etc. Using the adaptive control algorithm, the mean arterial pressure reduction is achived rapidly and safely in hypertensive rabbit. Among the adaptive control algorithms the pole assignment self tuning control algorithm is superial to the one step ahead minium variance control algorithm. The convergence time is less than 600 sec, and the standard deviation of experimental data are less than 4 mmHg.

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Correlations among Blood Pressures, Dietary Intakes and Other Environmental Factors in Korean Adult Males (성인 남성의 혈압과 식이섭취 실태 및 기타 환경 요인과의 관계에 대한 사례연구)

  • 이일하
    • Journal of the Korean Home Economics Association
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    • v.24 no.4
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    • pp.57-68
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    • 1986
  • The present survey was designed to investigate correlations among blood pressure, nutritional intakes, and various environmental factors in Korean adult males, and to observe the difference in dietary intakes between hypertensive patients and normotensive subjects. Two hundred forty-three adult men from Seoul and rural areas were interviewed about their food intakes, dietary patterns, food habits, and general environmental factors from December 20, 1982 to February 15, 1983. Their dietary intakes were surveyed by means of 24-hour recall diet method. Dietary score card was used in order to evaluate the quality of routine diet of the subject. Variables of environmental factors and factors related to hypertension were expressed as percentage, and the differences in nutrient intake and food score of each sub-group were examined by means of t-test. Correlation of all the variables were analyzed by Pearsons Correlation Coefficient. The results obtained are summarized as follows: 1. 38% of the subjects were between the ages of 40~49, and about one-half of the subjects were middle or high school graduates. 28% of the subjects earned 210, 000~350, 000 Won per month, and income distribution was almost identical to that of the urban population of Korea. 2. There was more overweight or obese found in the hypertensive patients than in the normotensive subjects. About 40% of the hypertensive patients reported a family history of hypertension, and their knowledge about hypertension was rather poor, but slightly better than the normotensive subjects. The patient group had less adherence to smoking and alcohol compared with the normotensive subjects, but no difference was observed in coffee drinking. The mean value of the blood pressure for the normotensive subjects was 127/86mmHg and 175/109mmHg for the hypertensive group. 3. Nutrient intake for the hypertensive group was lower for most of nutrients than in the healthy group. Hypertensive patients on diet therapy consumed less calories and carbohydrates compared with those who do not follow diet therapy. 4. There was no difference intake of these food groups between patients and the healthy group. Food score was strongly related to consumption of animal protein, saturated fats, Calcium, Iron, Vitamin A, Riboflavin, and Vitamin C, which are prone to be deficient in the typical Korean diet. 5. Blood pressure had a strong positive correlation with age, body weight, and socioeconomic level. In addition, monthly income was positively related with age and education level. 6. Three was a positive relationship between blood pressure and consumption of vegetable protein, and a negative relationship with consumption of Calories, Carbohydrates, Calcium, Iron, Vitamin A, Vitamin B1, Niacin, and Vitamin C. Animal protein intake increased as income and education levels increased, but this tendency was opposite for carbohydrates. In summary, nutritional intakes are strongly correlated with various environmental factors and the level of blood pressure. There was no difference between normotensive and hypertensive subjects with respect to the quality of food consumed except restricting energy and carbohydrate in the patient group.

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Adrenal incidentaloma: a case of asymptomatic pheochromocytoma

  • Park, Sang Yoong;Rim, Jong Cheol;Cho, Hyun Chul;Lee, Yoon Chan;Kim, Jung A;Choi, So Ron
    • Kosin Medical Journal
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    • v.33 no.2
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    • pp.215-222
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    • 2018
  • An incidentaloma is a tumor found incidentally without clinical symptoms or suspicion; the lesion may be adrenal, pituitary, or thyroidal. We report the case of an asymptomatic individual with preoperatively undiagnosed pheochromocytoma (size: 4.86 cm) that was revealed using elective nonadrenal surgical procedures. The patient demonstrated peri- and post-operative hypertensive crisis and tachycardia. Three days after the dramatic onset of symptoms, the patient expired due to pulmonary edema, multiple organ failure, and terminal sepsis, despite administration of extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation. A left medial kidney mass obtained at autopsy confirmed pheochromocytoma.

Renal artery stenosis presenting as congenital nephrotic syndrome with hyponatremic hypertensive syndrome in a 2-month-old infant: a case report

  • Dabin Kim;Yo Han Ahn;Hee Gyung Kang;Ji Hyun Kim;Seon Hee Lim
    • Childhood Kidney Diseases
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    • v.27 no.2
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    • pp.117-120
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    • 2023
  • Here, we present the case of a 2-month-old male infant with hyponatremic hypertensive syndrome resulting from stenosis of the right proximal and mid-renal arteries. The patient exhibited nephrotic-range proteinuria, low serum albumin, increased serum creatinine, and elevated renin and aldosterone levels. Doppler ultrasonography and computed tomography angiography revealed decreased vascular flow in the small right renal artery. Following a successful percutaneous balloon angioplasty, the patient experienced a decrease in blood pressure and normalization of serum electrolyte levels within a few days. However, it took 3 months for the proteinuria to resolve completely. This case is significant as it represents the first reported instance of a neonate presenting with clinical features resembling congenital nephrotic syndrome caused by renal artery stenosis that was successfully treated with percutaneous renal angioplasty.

Manifest Weeds and Self-Actualization of Patients with Essential Hypertension (본태성 고혈압 환자의 자기실현 및 욕구구조에 관한 연구)

  • 강익화
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.163-180
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    • 1978
  • Much of a person's energy is spent in the effort of becoming a productive member of to-day's complex society. This activity may cause tension, and chronic unrelieved tension is an influential factor in blood pressure elevation. The problem of this study was to identify manifest needs and self-actualization of patients with essential hypertension, and to analyse and compare their manifest needs and selt-actualization with the selected general characteristics of We, sex, religion, occupation and level of education with a control group of patients with normal blood pressure readings. The purpose was to contribute to the planning of nursing interventions toward reducing the impact of complex psycho-somatic factors on the anxiety of patients with essential hypertension. The instruments used included selected items from the Edwards (1959) Personal Preference Schedule (EPPS) as adapted by Hwang (1965) and from the Personal Orientation Inventory (POI) (Shostrom 1964, 1974) adapted by Kim and Lee (1977) to measure manifest needs and self-actualization. The convenience sample was chosen from 149 persons who presented themselves for general physical examinations at Ewha University Medical Centre and 41 patients diagnosed with essential hypertension at three general hospitals in Seoul during June 1 and August 31, 1977. Forty-nine persons from the Ewha group with blood-pressure readings exceeding 150/90 were added to the experimental group. Data were analysed by the S.P.S.S. computer programme using t-test and tests for statistical significance. Statistically significant findings were as follows: A. Blood Pressure and Manifest Needs. 1. with the exception of Autonomy, patients with hypertension had significantly high scores on all variables Abasement, Achievement, Affiliation, Aggression, Dominance, Emotionality, Exhibitionism and Sex. 2. When mean scores of normal persons were compared by age groups, normal persons had higher scores in the following order on Abasement (50's, 40's, 20's, 30's), Achievement (50's, 30's, 40's, 20's), Affiliation (50's, 40's, 30's, 20's), Dominance (50's, 40's, 40's, 20's) and Exhibitionism (30's, 50's, 40's, 20's). In each case, there was a significant difference between the first and last age group scores. 3. When the mean scores of normal persons were compared by sex, normal men had higher scores than women on Achievement, Affiliation, Aggression, Dominance, Exhibitionism and Sex. Male patients had higher scores than female patients on Achievement, Dominance, Exhibitionism and Sex, but female patients scored higher in Emotionality. 4. Normal persons had higher scores related to religion in the following order on Achievement (Buddhism, no religion, Christianity). Hyper tensive patients had higher scores on. Exhibitionism (no religion, Christianity, Buddhism). 5. Normal persons had higher scores related to occupation in the following order on Achievement and Exhibitionism (unemployed, office workers, teachless, businessmen), Emotionality (office workers, unemployed, businessmen, teacher) and Sex (office workers, unemployed, teachers, businessmen). Hypertensive patients had higher scores on Achievement and Aggression (teachers, businessmen, office worker, unemployed), Dominance and Exhibitionism (businessmen, teacher, of ace workers, unemployed) and Sex (teachers, office worker, businessmen, unemployed). 6. Normal persons had higher scores related to level of edification in the following order on Abasement, Emotionality and Autonomy (secondary school graduation, university). Hypertensive patients had higher scores on Abasement (no education, primary, university, secondary), Achievement (no education, secondary, university, primary) , Dominance (university, no education, secondary, primary), Exhibitionism (university, secondary, no education, primary), and Sex (university, secondary, primary, no education). B. Blood Pressure and Self_Actualization 1, Patients with hypertension had significantly lower scores on all variables. 2. Normal persons had higher scores related to age groups in the following order on Existentiality (20's, 30's, 40's, 50's). Hypertensive patients showed no significantly different scores. 3. Normal women had higher scores than men on Time Competence. Normal men had higher scores on Feeling Reactivity. Male patients had higher scores than women on Self-Actualizing Value and Self-Regard. 4. Normal persons ha 1 higher scores related to religion on spontaneity (Buddhism, no religion, Christianity). Hypertensive patients had higher scores on Time Competence and Nature of Man (Buddhism, Christianity, no religion). 5. Normal persons had higher scores related to occupation in the following order on Existentiality (teachers, office workers, businessmen, unemployed) and Self-Regard (unemployed, office workers, teachers, businessmen). Hypertensive patients showed no significantly different scores. 6. Normal persons had higher scores related to level of education in the following order on Existentiality and Self-Acceptance (university, secondary). Hypertensive patients had higher scores on inner-Director (university, secondary, no education, primary) and Existentiality (university, secondary, primary, no education). Recommendations for nursing interventions with hypertensive patients with emotional problems or low self-actualization were made. 1. The nurse should encourage the patient through her interactions with other members of the medical team to accept counselling and health education. 2. Through her therapeutic interpersonal relationships with the patient, the nurse should help him discover the causes of his emotional tension. 3. Through her health teaching with the family, the nurse should encourage them to participate with the medical team in the patient's therapeutic plan and in providing him with the minimum possible emotional support. 4. Through frequent counselling with the obsessive-thinking and inflexible patient, the nurse should reevaluate the patient's behaviour and her interventions. 5. Seriously ill patients should be given needed reeducation by members of the professional medical team.

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Status of Hypertensive Patients' Drug-taking in Health Center and Its related Factors (보건소 방문 고혈압환자의 약물복용 실태와 관련요인)

  • 서성희;박재용
    • Korean Journal of Health Education and Promotion
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    • v.15 no.2
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    • pp.23-42
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    • 1998
  • 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.

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A study on wiry pulse in hypertensive patients analyzed at 5 levels of applied pressure using 3 dimensional pulse imaging analyzer (3차원 로봇 맥 영상 분석기의 5단계 가압 맥파 분석에 의한 고혈압 환자의 현맥(弦脈) 연구)

  • Kang, Hee-Jung;Kwon, Young-Sang;Kim, Dal-Lae;Kim, Kyung-Cheol;Yim, Yun-Kyoung
    • Korean Journal of Acupuncture
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    • v.27 no.1
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    • pp.1-12
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    • 2010
  • Objectives: The purpose of this study is to gain the objective indicators for the classification of hypertension by oriental medical pulse diagnosis, through finding out the parameters which can distinguish the pulse of hypertensive patient from that of normal subject, and characterizes the wiry pulse of hypertension. Methods: 30-59 yr, male, 946 healthy volunteers and 35 hypertensive patients were enrolled in this study. All the hypertensive patients were taking medicine to control the blood pressure and the blood pressure of the hypertension group was not statistically different from that of the normal healthy group. Data were acquired using 3 dimensional pulse imaging analyser(DMP-3000, DAEYOMEDI, KOREA) and analysed according to the age bands and the applied pressure levels. Results: 1. RAI/t, w/t and t2/t decreased with the levels of applied pressure and increased with age in the normal healthy group, not in the hypertension group. 2. RAI/t, w/t, t2/t were significantly higher in the hypertension group than the normal healthy group in the 30-age band, and elasticity coefficient was higher in the hypertension group than the normal healthy group in the 40-age band. 3. Researches on the patients without hypotensive agents are needed to figure out whether these parameters are the components of hypertensive wiry pulse. Conclusions: Analysing the radial pulse at 5 applied pressure levels using 3 dimensional pulse imaging analyser may be useful to differentiate the pulses of the hypertensive patients from those of the normal subjects, and characterize the hypertension.

The Knowledge, Attitude and Practice of Blood Pressure Management from the Patient's Viewpoint: A Qualitative Study (고혈압 환자들의 관점에서 본 혈압관리에 대한 지식, 태도, 실천: 질적연구)

  • Lee, Sok-Goo;Jeon, So-Youn
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.4
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    • pp.255-264
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    • 2008
  • Objectives: This study adopted a qualitative method to explore the layman's beliefs and experience concerning high blood pressure and its management in order to develop a strategy to increase adherence to proper medical treatment. Methods: Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 26 hypertensive patients. The participants were selected according to a BP above 140/90 mmHg (hypertension stage 1), based on the seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-VII). The interviews lasted for approximately 30 minutes (range: 20-60 minutes). The resulting questions were formulated into open-ended questions. The interview questionnaire was composed 17 items to examine non-adherence to treatment and 19 items to examine adherence to treatment. Results: Most participants recognized that the direct cause of high blood pressure was unhealthy behavior rather than inheritance. Thus, the hypertensive patient believed they could recover their blood pressure to a normal level through removing the direct cause of hypertension (weight reduction, diet, exercise) instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural or they are artificial, and they may have side effects, and drugs are not treatment for the root cause of hypertension. Most of the hypertensive patients chose to manage their behaviors as soon as they knew their blood pressure was high. Therefore, we should not divide the subjects into two groups according to their taking drugs or not, but they should be divided into two groups according to their willingness or not to manage their condition. Conclusions: For developing a strategy for an individual approach to hypertension management, we need to develop a client-centered attitude and strategy. That is, we need to tailor our approach to individual cases to avoid generalizations and stereotyping when developing an adherence increasing strategy.

Structural Model on Hypertensive Patient's Lifestyle and Quality of Life (고혈압 환자의 생활양식과 삶의 질에 관한 구조 Model)

  • Lee Jong Ryol;Park Chun Man
    • Health Policy and Management
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    • v.14 no.3
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    • pp.66-96
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    • 2004
  • This study was intended to describe the hypertensive patient's lifestyle and quality of life by creating a hypothetic model on the lifestyle and quality of life and by examining a causeand effect relationship, and to contribute to countermeasures for practicing their lifestyle and improving the quality of life through creating a predictable model. Exogenous variable($\xi$) of hypothetic model in this study composed of a family support, hypertension knowledge, perceived benefit and toughness. Endogenous variable($\eta$) composed of self-esteem, perceived health state, depression, lifestyle and quality of life. There were 6 measured variables for exogenous variable(x). There were 9 measured variables(y) for endogenous variable. Also, there was error variable ($\delta,\;\epsilon$) of an individual. The survey was conducted for 207 hypertensive parents who received an out-patient service for 3 weeks from September 15, 2003 to October 3, 2003 after diagnosing as hypertension from 2 general hospitals in Daegu. As the conformance of hypothetic model in this study, there were $x^2$= 155.81, standard $x^2$ ($x^2$/df)=2.32, GFI=0.003, NFI=0.971, CFI=0.982, and RMSEA=0.080. Generally, the hypothetic model and actual data were well coincided. The higher the hypertension knowledge was(t=6.030), the higher the perceived benefit was(t=9.429), the higher the toughness was(t=2.783), and the higher the perceived health state was(t=2.282), the higher the lifestyle was. However, the degree of depression (t=-0.038), family support(t=1.161), and self-esteem(t=0.518) was not affected. The higher the family support was(t=10.476), the higher the self-esteem was(t=7.244), the higher the perceived health state was(t=6.996), the lower the degree of depression was(t=-2.044), and the higher the practice degree of lifestyle was(t=3.315), the higher the quality of life was. However, the toughness(t=1.672) didn't have a significant influence on the quality of life. It was modified to increase the model conformance and gain a conscious model As the result of model revision, for the model conformance, there were $x^2$= 118.43, standard $x^2$=1.69, GFI=0.923, NFI=0.976, CFI=0.982, and RMSEA=0.078. As the revised model showed the better conformance than hypothetic model, it seemed to be more suitable model. In the revised model, the perceived benefit(t=9.440) affected the lifestyle in the revised model. Then, the lifestyle was influenced by hypertension knowledge(t=6.139), toughness (t=2.757), family support(t=2.078), perceived health state(t=1.962) in the order. As a factor which affected the quality of life, there were the family support(t=l0.46l), self-esteem(t=7.368), perceived health state(t=6.989), lifestyle(t=3.316), toughness(t=2.584), and depression(t=-1.968) in the order. It showed the significant effect.

Effects of Venesection at the Sybsun-points on Blood Pressure and Body Temperature in Patients with Stroke (중풍환자에 있어 십선용사혈이 혈압 및 체온에 미치는 영향)

  • 이경진;구본수;김영석;강준권;문상관;고창남;조기호;배형섭;이경섭
    • The Journal of Korean Medicine
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    • v.21 no.1
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    • pp.62-67
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    • 2000
  • Background and Purpose: Sybsun-points are located at the tips of all fingers, 0.1chon from the finger nails, totaling 10 points on both hands. These points have been used for emergency care, fainting, epilepsy, cerebrovascular accidents, hypertension, unconsciousness, high fever etc. The most common technique is bleeding with a needle at these points. Hypertension and fever are the main factors for stroke patients’progress. We investigated whether venesection at Sybsun-points has effects on blood pressure and body temperature in stroke patients. Materials and Methods: 79 stroke patients were enrolled in this study from 1 Jan. 1999 to 30 Sep. 1999. All of them were admitted in Kyunghee University, Hospital of Oriental Medicine. Among them, 62 patients were hypertensive people, 17 were normal. Among the hypertensive patients, 27 were stage 1,20 were stage 2, 15 were stage 3 by classification of JNC 1997. All of the hypertensive patients had been taking drugs, while the normal group did not. From 2pm to 3pm, every 30 minutes we checked patients' blood pressure and body temperature by 24ABPM and tympanic thermometer. After 30 minutes passed, we phlebotomized patients Sybsun-points with Samneung needle 2-3cc of blood. Right after the bleeding, we checked blood pressure and body temperature. After the bleeding, for the next hour and a half, we checked each patient’s blood pressure and body temperature every thirty minutes, or a total of three times. We compared the blood pressure and the body temperature before and after treatment(p<0.05). Results: 1. Venesection at Sybsun-points significantly decreased systolic blood pressure on stage 3 hypertensive patients(p<0.0l). 2. Venesection at Sybsun-points significantly decreased diastolic blood pressure on stage 3 hypertensive patients(p<0.05) 3. Venesection at Sybsun-points had no effect on the change of body temperature. Conclusions: Though further study is needed, our findings suggest that Venesection at Sybsun-points may alleviate hypertension in stroke patients.

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