• 제목/요약/키워드: hypertension and diabetes

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보건진료소 중심 고혈압, 당뇨병 환자의 경험공유 자가관리 프로그램 효과 (Effects of an Experiences Sharing Self-management Program for Hypertension and Diabetes Patients in Primary Public Health Center)

  • 임정자;윤소영
    • 한국산학기술학회논문지
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    • 제21권7호
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    • pp.331-341
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    • 2020
  • 본 연구는 고혈압, 당뇨 환자를 대상으로 경험공유 자가관리 프로그램을 시행하여 대상자들의 생리적 지수, 지식, 자가관리 이행도에 미치는 효과를 파악하기 위해 시도된 비동등성 유사실험연구이다. 2018년 5월 1일부터 10월 31일까지 G시 보건진료소에 등록된 고혈압, 당뇨병 환자 실험군 30명, 대조군 25명을 대상으로 시행하였다. 실험군은 12주간의 경험공유 자가관리 프로그램에 참여하였고 대조군은 일반적인 보건진료소의 서비스를 제공하였다. 자료분석은 SPSS/WIN 22.0 프로그램을 이용하여 x2 test (Fisher's exact test), Mann-Whitney test, Ranked ANCOVA로 분석하였다. 연구결과 경험공유 자가관리 프로그램 적용 후 고혈압환자의 수축기혈압(F=14.56, p<.001), 이완기혈압((F=7.05, p=.012), 지식(F=14.30, p=.001), 자가관리 이행도(F=29.73, p<.001)에서 두 군간에 유의한 차이가 있었고, 당뇨병 환자의 지식(F=7.92, p=.010), 자가관리 이행도(F=4.54, p=.044)에서 두 군간에 유의한 차이가 있었다. 따라서 지역사회 고혈압 환자의 혈압감소와 고혈압, 당뇨병 환자의 지식향상, 자가관리 이행증진을 위해 경험공유를 활용한 자가관리 프로그램은 효과적이라 생각된다.

Effect of coadministration of enriched Korean Red Ginseng (Panax ginseng) and American ginseng (Panax quinquefolius L) on cardiometabolic outcomes in type-2 diabetes: A randomized controlled trial

  • Jovanovski, Elena;Smircic-Duvnjak, Lea;Komishon, Allison;Au-Yeung, Fei (Rodney);Sievenpiper, John L.;Zurbau, Andreea;Jenkins, Alexandra L.;Sung, Mi-Kyung;Josse, Robert;Li, Dandan;Vuksan, Vladimir
    • Journal of Ginseng Research
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    • 제45권5호
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    • pp.546-554
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    • 2021
  • Background: Diabetes mellitus and hypertension often occur together, amplifying cardiovascular disease (CVD) risk and emphasizing the need for a multitargeted treatment approach. American ginseng (AG) and Korean Red Ginseng (KRG) species could improve glycemic control via complementary mechanisms. Additionally, a KRG-inherent component, ginsenoside Rg3, may moderate blood pressure (BP). Our objective was to investigate the therapeutic potential of coadministration of Rg3-enriched Korean Red Ginseng (Rg3-KRG) and AG, added to standard of care therapy, in the management of hypertension and cardiometabolic risk factors in type-2 diabetes. Methods: Within a randomized controlled, parallel design of 80 participants with type-2 diabetes (HbA1c: 6.5-8%) and hypertension (systolic BP: 140-160 mmHg or treated), supplementation with either 2.25 g/day of combined Rg3-KRG + AG or wheat-bran control was assessed over a 12-wk intervention period. The primary endpoint was ambulatory 24-h systolic BP. Additional endpoints included further hemodynamic assessment, glycemic control, plasma lipids and safety monitoring. Results: Combined ginseng intervention generated a mean ± SE decrease in primary endpoint of 24-h systolic BP (-3.98 ± 2.0 mmHg, p = 0.04). Additionally, there was a greater reduction in HbA1c (-0.35 ± 0.1% [-3.8 ± 1.1 mmol/mol], p = 0.02), and change in blood lipids: total cholesterol (-0.50 ± 0.2 mmol/l, p = 0.01), non-HDL-C (-0.54 ± 0.2 mmol/l, p = 0.01), triglycerides (-0.40 ± 0.2 mmol/l, p = 0.02) and LDL-C (-0.35 ± 0.2 mmol/l, p = 0.06) at 12 wks, relative to control. No adverse safety outcomes were observed. Conclusion: Coadministration of Rg3-KRG + AG is an effective addon for improving BP along with attaining favorable cardiometabolic outcomes in individuals with type 2 diabetes. Ginseng derivatives may offer clinical utility when included in the polypharmacy and lifestyle treatment of diabetes. Clinical trial registration: Clinicaltrials.gov identifier, NCT01578837;

일부 종합검진 수진자에서의 혈압, 혈당 및 혈중지질과 관련된 위험요인 (The Risk Factors Associated with Increased Blood Pressure, Sugar and Lipids in Multi-phasic Health Checkup Examinee)

  • 조상덕;홍현숙;이강숙
    • Journal of Preventive Medicine and Public Health
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    • 제33권1호
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    • pp.69-75
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    • 2000
  • Objectives : This study was conducted to evaluate the risk factors associated with cardiovascular disease. Methods : By the questionnaire, the informations of education level, monthly income, alcohol consumption and smoking habit were obtained. Height, weight and blood Pressure(BP) were measured by a trained nurse. The level of lasting blood sugar(FBS), total cholesterol, hight-density lipoprotein(HDL) cholesterol and triglyceride were tested by enzyne method about a group of 2888 males and 1696 females ages ever 20 who had never taken the medication for hypertension. Statistical analysis, ANOVA, stepwise multiple regression, correlation analysis were peformed using SAS package program. Results : There were significant differences among age groups in systolic and diastolic blood pressure, body mass index(BMI), FBS, triglyceride and cholesterol except HDL-cholesterol. The risk factors associated with systolic and diastolic BP significantly in male were BMI, age, alcohol intake, but in female BMI, age. Smoking habit had a significant negative correlation with BP in both sex. In the group of mild hypertension ($\geq140\;mmHg\;or\geq90\;mmHg$ defined by JNC-VI) and hypertension ($\geq160\;mmHg\;or\;\geq95\;mmHg$ defined by WHO), the percent of diabetes $(FBS\geq140\;mg/dl)$, hypercholesterolemia $(\geq240mg/dl)$, and hypertriglyceridemia $(\geq200\;mg/dl)$ were significantly higher compared with normal group in male and female. BMI, and alcohol consumption had a positive correlation with FBS, total cholesterol and triglyceride. Smoking had a positive correlation with cholesterol and triglyceride but negative correlation with HDL-cholesterol in male. The educational attainment had a negative correlation with BMI, FBS, total cholesterol and triglyceride in female. Conclusions : This study suggested that drinking, smoking, and BMI and lower educational level were associated with hypertension, hyperlipidemia and diabetes, but further evaluation was needed by prospective intervention study.

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Risk factors, depression, quality of life and relevance of Korean adults

  • Ahn, Si-Nae
    • International journal of advanced smart convergence
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    • 제8권3호
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    • pp.7-12
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    • 2019
  • This study aimed that certain risk factors are linked to the risk of developing depression and decreasing quality of life. This study was implemented using data from the 6th and 7th Korea National Health and Nutritional Examination Survey. The National Health and Nutrition Survey consist of health surveys, screenings, and nutrition surveys. Among the risk factors, data on adult diseases such as depression, hypertension, arthritis, diabetes, cataract, glaucoma, and macular degeneration were used. In total, 12,768 adults over 20 years of age were selected, of whom 520 were diagnosed with depression. The most common risk factors in adults over 20 years of age were hypertension, arthritis, cataract, diabetes, depression, glaucoma, and macular degeneration. Their risk factors were analyzed if these were associated with depression and quality of life. The results revealed that hypertension, arthritis, diabetes, cataract, glaucoma, and macular degeneration were predictors for the occurrence of depression in adults. The factors associated with the highest risk for depression were arthritis and glaucoma. Furthermore, the study investigated the effect of certain factors on the quality of life; the factor associated with the greatest impact on quality of life was arthritis. This study verified that the aforementioned factors were related to the risk of developing depression and decreasing quality of life.

고혈압을 동반한 당뇨병에서 유병기간에 따른 뇌졸중 위험도 (Risk of Stroke according to the Duration of Diabetes Mellitus with Hypertension)

  • 김희성
    • 대한임상검사과학회지
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    • 제52권3호
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    • pp.188-193
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    • 2020
  • 뇌졸중은 사망발생 및 장애를 일으키는 주요 원인 질환이며, 당뇨병은 뇌졸중의 주요 위험인자이다. 당뇨병 환자가운데 뇌졸중을 동반한 환자에서 적정 혈압 관리의 중요성을 알아보고자 한다. 제6기 국민건강영양조사 자료를 바탕으로 18세 이상 80세 미만자 총 16,389명을 대상으로 회귀분석을 통하여 당뇨병 유병기간에 따른 혈압조절을 통한 뇌졸중의 위험도를 산정하였다. 당뇨병 유무에 따른 뇌졸중의 유병률은 당뇨병 환자 군에서 높았고, 당뇨병의 유병기간이 길어질수록 고혈압과 뇌졸중의 위험도는 상승하였으며, 당뇨병과 고혈압에 대한 치료 비율은 높았다. 고혈압군에 비해 적정 혈압 유지군(<140/<90 mmHg)에서 뇌졸중 위험비(HR)는 0.57 낮았다. 당뇨병과 고혈압에 대한 치료가 동반됨에도 불구하고 고혈압의 빈도는 상승하였고, 당뇨병 유병기간 5년 이후 뇌졸중의 유병률이 상승함에 따라 이 시기의 효과적인 혈압관리가 더욱 중요하다. 당뇨병 환자에서 지속적으로 적정 혈압으로 관리함으로써 뇌졸중 위험도를 낮추는 것이 중요하다.

당뇨병성 신장질환 환자에서 적정 혈압 관리의 중요성 (Importance of Target Blood Pressure Management in Diabetic Kidney Disease)

  • 김희성
    • 한국콘텐츠학회논문지
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    • 제19권6호
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    • pp.461-470
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    • 2019
  • 신장질환은 당뇨병환자에서 흔한 합병증이며, 알부민뇨 배설의 증가, 사구체여과율의 감소가 특징적이다. KDIGO 분류에 따라 6기 국민건강영양조사 원시자료를 이용하여 알부민뇨와 사구체여과율에 따라 특성을 분석하였다. 당뇨환자를 KDIGO의 분류에 따라, Low risk 72.0%, Moderate risk 19.3%, High risk 5.6%, Very high risk 3.0%이었다. 당뇨병 유병기간이 길어질수록 Low risk는 74.7%에서 52.2%로 감소하였고, Moderate~Very high risk는 25.4%에서 47.8%로 상승하였다. 위험요인은 CKD stage 1 (HR 2.064) ~ stage 4 (HR 11.049)로 고혈압의 위험도가 가장 높았다. 고혈압 유병기간에 따라 신장질환의 발생빈도는 상승하였고, 적정 혈압을 유지하는 군에서 신장질환의 위험도 0.42가 감소하였다. 고혈압 환자에서 적정 혈압으로 관리하는 군이 그렇지 않은 군보다 42%의 신장질환의 감소효과가 있었다. 그러므로 고혈압을 적정혈압으로 조절 및 관리하는 것이 신장질환의 예방에 있어 중요하다.

대상자 중심의 만성질환 자가관리 프로그램: 고혈압, 당뇨병을 중심으로 (Client-Centered Self Management Program for Chronic Disease Patients: Focusing on Hypertension, Diabetes Mellitus)

  • 송연이;이강숙;조현영;이빛나
    • 보건교육건강증진학회지
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    • 제31권4호
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    • pp.93-106
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    • 2014
  • Objectives: The aim of this study was to develop the efficient program protecting shift to cerebrovascular disease as complication for patients with diabetes and hypertension. Methods: Chronic disease self management program(CDSMP), implement manual, action plan, Q&A card and motivation methods were suggested based on Bandura's social learning theory through reviewing various literatures and cases. Results: This program can increase self-efficacy, individual health behavior change and quality of life and it makes to continuous care of chronic disease. Conclusion: In order to operate chronic disease self-management program, standardized education courses training of specialist leaders and expert patients leaders would be required. And the development enlargement of self-management program for various other chronic disease such as arthritis, back pain, atopy, asthma would be required in the future.

군병원 만성질환자의 처방전분석 및 약물상호 작용 검토 (A Study on Chronic Outpatients' Prescriptions and Drug Interactions Based on Prescriptions in Army Hospital)

  • 조유미;손의동
    • 약학회지
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    • 제47권6호
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    • pp.382-389
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    • 2003
  • This study has collected prescriptions of individual chronic outpatients in an army hospital, analysed them, and investigated the possible drug interactions. It also reviewed the mechanism of drug interactions. Out of total of 42 outpatients with chronic diseases, the percentages of populations having hypertension, hypertension with diabetes, uncomplicated diabetes, hyperlipidemia, hypertension with cardiac insufficiency, and ventricular septal defect were 62%, 19%, 10%, 5%, 2%, and 2%, in the corresponding order. The average number medications prescribed for the outpatients were 2.5 with the highest frequency of five medications in two patients. The number of drug-drug interactions detected was 456 prescriptions out of total of 1104 prescriptions during the study period, accounting for 41.3%. The most frequent drug-drug interaction was between beta-blockers and calcium channel blockers with 132 prescriptions followed by one between beta-blockers and cimetidine with 89 prescriptions. Based on the high incidence of possibly dangerous drug interactions, much attention needs to be aid to the drug-drug interactions in the pharmacotherapy for the treatment of outpatients with chronic diseases in army hospital setting.

만성질환자의 정기적 의료이용에 영향을 미치는 요인 - 고혈압, 당뇨병, 고지혈증을 중심으로 - (Factors Affecting Regular Medical Services Utilization of Chronic Disease Patients - Focusing on the Hypertension, Diabetes Mellitus, Hyperlipidemia -)

  • 서영숙;박종호;임지혜
    • 보건교육건강증진학회지
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    • 제31권3호
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    • pp.27-37
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    • 2014
  • Objectives: This study aims to identify the factors associated with regular medical services utilization of chronic disease patients. Methods: The research selected 4,489 adults aged over 30, diagnosed with hypertension, diabetes, hyperlipidemia, hypercholesterolemia, from the Korea health panel. We analyzed states of regular medical service utilization using descriptive statistics. Multiple regression analysis was used to examine the main factors associated with regular medical services utilization in chronic disease patients. Results: In terms of socio-demographic factors, gender, age, marital status, education level, employment, household income and disability were significantly different between hypertension, diabetes, hyperlipidemia and hypercholesterolemia. Among health status and behavioral factors, number of chronic diseases, subjective health status, smoking, high risk drinking, regular meals, physical activity, obesity were significantly different. From the multiple logistic regression analysis, age, number of chronic diseases, obesity, type of chronic diseases were associated with regular medical services utilization. Conclusions: It is necessary to develop effective health education programs and individualized approach to improve continuous management in chronic diseases patients.

성별, 연령별, 월소득차이에 따른 질병발생의 위험성 차이연구;암, 고혈압, 중풍, 당뇨병, 관절염, 심장병을 중심으로 (The Risk of Onset of the Illnesses Based on Gender, Age, and Monthly Income;Focusing on cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders)

  • 이준오;김세진;이선동
    • 대한예방한의학회지
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    • 제12권1호
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    • pp.19-48
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    • 2008
  • In order to verify the risk of onset of the illnesses based on gender, age, and monthly income 1,739 subjects from Hongcheon county, Gangwon province were selected. Questionnaire on demographic sociology, health condition, existence of illnesses(cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders), and usage of public health services was surveyed from October 1, 2006 to October 20, 2006. Following conclusions were reached on the basis of the questionnaire : - For demographic sociological peculiarities, gender, age, occupation, and education level were evenly distributed. Most were under normal marriage(67.38%), health insurance(86.39%), 494(36.0%) individuals with less than monthly income of 1 million won, 494(36.0%) individuals with monthly income between 1 and 2 million won, 219(16.0%) with monthly income between 2 and 3 million won, and 164(12.0%) individuals with more than 3 million won, thus showing relatively low income. - For health status, 1,199(70.28%) individuals are non-smokers, 209(45.63%) individuals smoke $10{\sim}20$ cigarettes a day, 754(44.02%) individuals exercise less than twice a week are the major sector of the population. 1,518(88.10%) individuals have regular checkup more than once and 1,131(65.49%) stated their health condition less than average. - For comparison of existence of illnesses between genders, there was no statistical significance on cancer, stroke, and diabetes. But statistical significance was shown on hypertension(P value 0.025), arthritis(P value 0.000), and cardiac disorders(P value 0.016). Statistical significance was seen in the age comparison, and OR(confidence interval) drastically increased with increase in age. - There was no difference between the primary health clinic(P value 0.000), most visited clinic(P value 0.000), selection criteria(P value 0.000), and satisfaction on efficacy(P value 0.000). There was a tendency preferring hospital than public health center with increase in income. - For correlation between the existence of illnesses among different income levels, except for cancer(P value 0.172), statistical significance was seen in hypertension(P value 0.000), stroke(P value 0.003), diabetes (P value 0.001), arthritis(P value 0.000), and cardiac disorders(P value 0.000). The number of individuals suffering from illnesses and ratio all decreased for all illnesses with increase in income. - After adjusting confounding factors(gender, age, income, marriage, occupation, education) and male (1) as the standard, OR (confidence interval) of cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders were 0.47(0.11${\sim}$2.05), 1.27(0.89${\sim}$1.81), 0.58(0.21${\sim}$1.59), 0.71(0.41${\sim}$1.23), 1.79(1.34${\sim}$2.39, P<0.01), and 1.46(0.72${\sim}$2.96), respectively. Risk of arthritis is significantly high in female and 20's (1) as the standard, OR(confidence interval) of cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders were 1.01(0.96${\sim}$1.07), 1.06(1.04${\sim}$1.07, P<0.01), 1.05(1.01${\sim}$1.10, P<0.01), 1.06(1.03${\sim}$1.08, P<0.01), 1.05(1.03${\sim}$1.06, P<0.01), and 1.06(1.04${\sim}$1.09, P<0.01), respectively. Risk of onset for illnesses significantly increased with yearly aging except for cancer. - For comparison between monthly income after adjusting confounding factors(gender, age, income, marriage, occupation, education), with less than 1 million won (1) as the standard, OR(confidence interval) of cancer for 1 to 2 million won, 2 to 3 million won, and more than 3 million won were 0.23(0.03${\sim}$2.16), 2.53(0.41${\sim}$15.43), and 1.73(0.15${\sim}$19.50), respectively. OR(confidence interval) of hypertension were 1.12(0.76 ${\sim}$1.66), 0.68(0.34${\sim}$1.34), and 2.04(1.08${\sim}$3.86, P<0.01), respectively. OR(confidence interval) of stroke were 0.96(0.30${\sim}$3.08) for 1 to 2 million won, and 0.80(0.08${\sim}$8.46) for 2 to 3 million won. OR(confidence interval) of diabetes were 0.73(0.38${\sim}$1.38), 0.65(0.24${\sim}$1.71), and 0.69(0.24${\sim}$2.01), respectively. The values were 0.76(0.55${\sim}$1.03), 1.14(0.75${\sim}$1.73), and 0.90(0.56${\sim}$1.46), respectively for arthritis. OR(confidence interval) of cardiac disorders were 1.15(0.53${\sim}$2.48), 0.63(0.13${\sim}$3.12), and 1.20(0.28${\sim}$5.14), respectively. Risks of cancer, hypertension, stroke, diabetes, arthritis, and cardiac disorders were dependent of monthly income, and stroke and diabetes decreased with increase in income. Summarizing above data, arthritis was significantly higher in women and increase in age by each year brought significant increase in the chance of onset in hypertension, stroke, diabetes, arthritis, and cardiac disorders except for cancer. Stroke and diabetes decreased with increase in income. Above findings can be applied and reflected in public health policies at the national level, and it can also be applied at the personal level for individual health maintenance and prevention.

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