• Title/Summary/Keyword: Secondary hypertension

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Factors Influencing Medication Adherence in Patients with Hypertension: Based on the 2008 Korean National Health and Nutrition Examination Survey (고혈압 환자의 약물복용 이행에 영향을 미치는 요인: 2008년 국민건강영양조사를 이용하여)

  • Cho, Eunhee;Lee, Chung Yul;Kim, Insook;Lee, Taewha;Kim, Gwang Suk;Lee, Hyeonkyeong;Ko, Jisook;Lee, Kyongeun
    • Research in Community and Public Health Nursing
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    • v.24 no.4
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    • pp.419-426
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    • 2013
  • Purpose: The purpose of this study is to examine factors influencing medication adherence in patients with hypertension. Methods: This study carried out a secondary analysis of data from the 2008 Korean National Health and Nutrition Examination Survey (KNHANES). Stratified sampling was used to select a participant sample that was representative of patients with hypertension throughout the country. Using the SPSS/WIN 18.0 program, data were analyzed using descriptive statistics, $x^2$ test, t-test, and logistic regression. Results: Of the patients with hypertension, 8.8% had showed non-adherence to medication. Medication adherence was associated with age, spouse, Medicare insurance, number of other diseases, and current smoking status. The cases with older age, a spouse, Medicare insurance, higher number of other diseases, and no current smoking status showed significantly high medication adherence. Conclusion: Nursing interventions and further studies are needed to achieve high levels of medication adherence based on factors influencing medication adherence such as age, spouse, Medicare insurance, number of other disease, and current smoking status.

Analysis of Factors Affecting Medication Adherence to Improve Life Care in Patients with Hypertension (고혈압 환자의 라이프케어 증진을 위한 약물 순응도 영향요인 분석)

  • Gil, Eun-Ha
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.2
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    • pp.213-224
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    • 2020
  • Purpose: This study is a descriptive and secondary analytical study that uses panel data to identify the factors of medication adherence to improve life care of hypertensive patients. Methods: The subjects of this study were 2,484 patients who were taking medication after hypertension using Korea Medical Panel 2015 data (β-version 1.0). Data analysis was performed using Chi-Square, Scheffe's test, and logistic regression using SPSS/win 22.0. Results: The level of medication adherence in patients with hypertension was 94.2%. The factors of medication adherence were gender and age in Model I of demographic factors, and the presence of disability, smoking, and drinking in Model II. Model III, which added drug use factors, was identified as drinking, drug duration, side effects, drug satisfaction, and payment of drug costs. Conclusion: In order to improve life care for hypertension patients, education and interventions on the importance of take medication and side effects of medications and how to take them will be needed in the early stages of diagnosis.

Management of Pulmonary Hypertension Due to Brachycephalic Obstructive Airway Syndrome in a Dog

  • Song, Yunji;Kim, Yeji;Kim, Jihyun;Kim, Kwon-Neung;Oh, Songju;Kim, Ha-Jung
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.240-245
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    • 2022
  • A 15-year-old, neutered male, Shih-Tzu, was presented at the Chonnam National Veterinary Medical Teaching Hospital for evaluation of acute onset of persistent coughing, exercise intolerance, and abnormal heart sound. On thoracic auscultation, a split-second heart sound and a wheezing sound were detected on both sides of the chest walls. On physical examination, the dog's body condition score (BCS) was 7/9, and had stenotic nares. Thoracic radiographs revealed right-sided enlargement of the cardiac silhouette (vertebral heart score (VHS) 11.2; reference interval = 8.9-10.1), mild main pulmonary artery (MPA) bulging, mild interstitial infiltration, and hepatomegaly. The electrocardiogram showed right axis deviation, suggesting right ventricular hypertrophy. The echocardiographic study showed moderate pulmonary hypertension and moderate tricuspid regurgitation. There were no findings of a tracheobronchial disease, pulmonary thromboembolism, congenital shunt, left heart disease, or parasitic disease. Based on clinical signs and diagnostic findings, the dog was diagnosed with pulmonary hypertension secondary to brachycephalic syndrome. To rectify respiratory exacerbating factors, the dog was recommended weight control by restricting dietary intake and managing concurrent Cushing's syndrome. Treatments included sildenafil, pimobendan, furosemide, and ramipril. After five months of taking medications and weight control, the severity of pulmonary hypertension improved from moderate to mild. The clinical signs of the patient, including coughing and exercise intolerance, improved a lot. For 5 months of follow-up, the patient has not reported further recurrence of respiratory distress.

Severe chest pain with mid-ventricular obstruction in a patient with hyperthyroidism

  • Nam, Jong-Ho;Son, Jang Won;Hong, Geu-Ru
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.128-131
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    • 2017
  • Mid-ventricular obstruction (MVO) rarely occurs in patients without hypertrophic cardiomyopathy. Increased cardiac contractility may play an important role in causing MVO. We experienced a case of severe chest pain and MVO in a 50-year-old female patient. She had hypertension, diabetes, stroke and peripheral artery disease. Her blood pressure was very high (222/122 mmHg) with severe fluctuation. The transthoracic echocardiography revealed MVO accompanied by hyper-dynamic left ventricular systolic function. We regarded her chest pain and MVO as secondary findings related to other diseases. Coronary angiography and several tests for uncontrolled hypertension were performed, and those evaluations revealed that she had coronary artery disease and hyperthyroidism. We considered that the increase in the myocardial oxygen demand in response to the increase in cardiac contractility and workload associated with hyperthyroidism aggravated her symptoms and MVO. She was treated with methimazole and beta blockers and her symptoms dramatically improved.

Aneurysm of the main pulmonary artery associated with patent ductus arteriosus (동맥관 개존증을 동반한 주폐동맥의 동맥류 치험 1예)

  • Youm, Wook;Cho, Dae-Yun;Rho, Joon-Ryang
    • Journal of Chest Surgery
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    • v.15 no.4
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    • pp.381-386
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    • 1982
  • Pulmonary artery aneurysm usually carries an ominous prognosis due to the associated pulmonary hypertension. In July 1981, a patient with a huge aneurysm of main pulmonary artery secondary to pulmonary hypertension and bacterial endocarditis due to a patent ductus arteriosus was treated by resection of the aneurysm and Dacron patch graft replacement and closure of the patent ductus arteriosus. The immediate postoperative result was excellent. We now report the surgical treatment, clinical course, and one and half years follow up of the patient.

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An Extra-adrenal Pheochromocytoma Presenting with Spontaneous Intracerebral Hematoma

  • Park, Seong-Keun;Lee, Jung-Kil;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.38 no.1
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    • pp.61-64
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    • 2005
  • We report a 18-year-old man, who has been taking antihypertensive medication for 1month in a local clinic, presented with a sudden onset headache followed by left blindness. He experienced palpitation and chest discomfort during physical exertion since 2years before admission, but unfortunately has been ignored. Brain CT showed intracerebral hemorrhage in the left temporoparietal area, but cerebral angiogram and magnetic resonance image revealed no vascular anomaly. He was managed conservatively, and headache and visual loss were improved over time. Subsequently, on the evaluation of hypertension, he was diagnosed as having extra-adrenal pheochromocytoma on left paraaortic area from the results of endocrinological evaluations, abdominal CT scan, and $^{131}I$-MIBG scintigraphy.

Primary Aldosteronism and Cerebrovascular Diseases

  • Chen, Zheng-Wei;Hung, Chi-Sheng;Wu, Vin-Cent;Lin, Yen-Hung;TAIPAI study group
    • Endocrinology and Metabolism
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    • v.33 no.4
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    • pp.429-434
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    • 2018
  • As diagnostic techniques have advanced, primary aldosteronism (PA) has emerged as the most common cause of secondary hypertension. The excess of aldosterone caused by PA resulted in not only cardiovascular complications, including coronary artery disease, myocardial infarction, arrhythmia, and heart failure, but also cerebrovascular complications, such as stroke and transient ischemic attack. Moreover, PA is associated more closely with these conditions than is essential hypertension. In this review, we present up-to-date findings on the association between PA and cerebrovascular diseases.

Study on the Clonality of Endothelial Cell Proliferation in Plexiform Lesions in Patients with Pulmonary Hypertension Associated with CREST Syndrome (CREST 증후군에 동반된 폐고혈압 환자에서 총상병변내 내피세포 증식의 클론성에 관한 연구)

  • Lee, Sang-Do;Jeon, Yong-Gam;Lee, Ji-Hyun;Shim, Tae-Sun;Lim, Chae-Man;Koh, Yun-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Tuder, Rubin M.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.150-160
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    • 1999
  • Background: The CREST syndrome is an indolent form of progressive systemic sclerosis. Although its clinical progress is indolent, pulmonary hypertension(PH) associated with CREST syndrome have grave prognosis with over 40 percent mortality rate at 2 year follow-up. But the pathogenesis of pulmonary hypertension in this disease is not known, and classified as either primary or secondary PH. Clonality of endothelial cell proliferation in plexiform lesion is a molecular marker which allows distinction between primary and secondary PH. We performed this study to know whether the PH associated with CREST syndrome is a variant of primary PH or is a secondary PH. Methods: We assessed the X-chromosome inactivation based on the methylation pattern of the human androgen-receptor gene by PCR(HUMARA). Endothelial cells in plexiform lesions from female patients(n=3) with PH associated with CREST syndrome were microdissected from paraffin blocks. Vascular smooth muscle cells and lung parenchyma were also microdissected for clonality studies. Results: The proliferating endothelial cells in 14 plexiform lesions were all polyclonal. Similarly proliferated smooth muscle cells from 5 vessels with medial hypertrophy were also polyclonal. Conclusion: These results suggest that the pulmonary hypertension associated with CREST syndrome has different pathogenesis from primary PH and to be classified as secondary PH.

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A Study of Occurrence of Secondary Complications and Chronic Diseases due to Aging of Spinal Cord Injury (척수손상환자의 고령화에 따른 2차합병증 발생과 만성질환발병에 관한 연구)

  • Min, Yeo Jin;Kim, Jong Bae
    • 재활복지
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    • v.22 no.4
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    • pp.83-102
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    • 2018
  • The purpose of this study is to provide basic data for effective management and prevention of chronic diseases and secondary complications as elderly spinal cord injuries(SCI). The subjects were 200 spinal cord injuries admitted to S hospital from April, 2013 to April, 2018. We investigated the occurrence of chronic diseases and secondary complication through medical records. The results showed that SCI were affected chronic diseases and secondary complications over 50years. The prevalence of chronic diseases and secondary complications over 50 years of age had the odds ratio 11.8 times higher in hypertension and 6.7 times diabetes mellitus. Secondary complications had the odds ratio Osteoporosis 7.5 times, Pneumonia 5.2 times, and central pain 0.4 times. We suggest that continuous management and service of chronic diseases and secondary complications of elderly SCI are necessary. It will be necessary to expand the target population and to study various characteristics including.

Diagnosis of Primary Aldosteronism and Usefulness of Aldosterone/Renin Ratio in Secondary Hypertension (이차성 고혈압 환자에서 알도스테론/혈장 레닌활성도 비율을 이용한 원발성 알도스테론증의 진단 및 임상적 유용성 평가)

  • Kim, Hye-Sook;Kwon, Won-Hyun;Moon, Ki-Choon;Lee, In-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.241-246
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    • 2008
  • Purpose: To study of difference among primary aldosteronism patients and normal groups and essential hypertension patients and to confirm aldosterone/plasma renin activity ratio increase in secondary hypertension group which was diagnosed as primary aldosteronism. Materials and method: 1. Period: from April 2006 to March 2008. 2.Targets: 901 patients who visited seoul national university bundang hospital. 3. Groups: we divided by three groups. (normal group (n=147), essential hypertension (n=709), primary aldosteronism (n=45)) 4. Then calculated aldosterone/plasma renin activity ratio. 5. We used ROC curve to measure sensitivity and specificity. Results: 1. normal groups aldosterone/plasma renin activity ratio: $52.8{\pm}52.46$ essential hypertension patients aldosterone/plasma renin activity ratio: $171.04{\pm}291.56$ primary aldosteronism patients aldosterone/plasma renin activity ratio: $2325{\pm}2200$. 2. Aldosterone/renin ratio was significant in comparing each groups (p<0.001). 3. The sensitivity was 91.1% and the specificity was 92.4% when cut off of aldosterone/renin ratio was 485. Conclusion: It was confirmed that aldosterone/plasma renin activity ratio in primary aldosteronism was higher than normal group. According to this result, we can tell that aldosterone/ plasma renin activity ratio is very useful in diagnosis of primary aldosteronism.

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