• Title/Summary/Keyword: hypertensive patients

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A Study on Compliance of Hypertensive Patients Registered at Community Health Practitioner Post (보건진료소에 등록된 고혈압 환자의 순응도 연구)

  • Cha, Sun-Sook;Kim, Keon-Yeop;Lee, Moo-Sik;Na, Back-Joo;Park, Jung-Hwan;Yu, Taec-Soo
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.101-111
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    • 2005
  • Objectives: This study was to evaluate the compliance of hypertensive patients and its related factors registered at Community Health Practitioner Post(CHCP). Methods: 304 patients were interviewed by trained nursing students during one month(June~July 2004). The questionnaire included general charactristics, knowledge of hypertension, health education experience, constructs of Health Belief Model, self efficacy and so on. Compliance group was defined "having regularly medication and good life style". Good life style included regular exercise, non-smoking, little alcohol, low salt diet, weight control. Results: In compliance group 90.3% of man and 93.3% of woman were regularly taking hypertensive medicine, and 45.2% of man and 56.4% of woman were having good life style (compliance group). In both man and woman, the group of higher education were more compliance group, but were statistically significant were in man(p<0.05). In woman, the compliance group have significantly higher score in knowledge of hypertension(p(0.05). The compliance group have significantly higher self-efficacy score in both man and woman (p<0.05). In Health Belief Model, susceptibility and benefit were statistically significant in man, seriousness, benefit and barrier in woman(p<0.05). In multiple logistic regression analysis, education level and self efficacy in man and knowledge of hypertension, self-efficacy and benefit in woman were significant variables (p<0.05). Conclusions: It is very important to evaluate and modify life-style adding to having regularly medication in hypertensive patients registered at CHCP. To this, health education programs about benefit to compliance and the methods to improve self-efficacy should be developed for this patients.

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Effect of sodium restriction on blood pressure of unstable or uncontrolled hypertensive patients in primary care

  • De Keyzer, Willem;Tilleman, Katrien;Ampe, Jan;De Henauw, Stefaan;Huybrechts, Inge
    • Nutrition Research and Practice
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    • v.9 no.2
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    • pp.180-185
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    • 2015
  • BACKGROUND/OBJECTIVES: The aims of the present study are: 1) to quantify sodium consumption of patients with unstable or uncontrolled hypertension, 2) to investigate if reduced sodium intake can lower BP in these patients, and 3), to assess the acceptability and feasibility of this approach. SUBJECTS/METHODS: This study included 25 adults (age: 50+ years) with frequently elevated BP or patients with uncontrolled, uncomplicated hypertension despite drug treatment in a general practice setting. BP and salt intake (24h urinary excretion and food records) were measured at baseline and after a sodium reduced diet. RESULTS: Mean (${\pm}SD$) systolic (SBP) over diastolic (DBP) blood pressure (mmHg) at baseline was $150.7({\pm}9.5)$/$84.149({\pm}5.6)$. Mean urinary sodium excretion was 146 mmol/24h. A reduction of 28 mmol sodium excretion decreased SBP/DBP to $135.5({\pm}13.0)$/$82.5({\pm}12.8)$ (P < 0.001). After one month of no dietary advice, only in 48%, SBP was still ${\leq}140mmHg$. CONCLUSION: Assessment of sodium intake using food records, 24h urine collections and probing questions to identify use of sodium containing supplements or drugs are essential for tailored advice targeted at sodium intake reduction. The results of the present study indicate that reduced sodium intake can lower BP after 4 weeks in unstable or uncontrolled hypertensive patients.

Association between Korean Medicine Hospital Utilization and Cardiovascular Risks in Patients with Hypertension: a National Korean Cohort Study (고혈압 환자에서 한방의료기관 이용과 심혈관 위험 요소와의 관계: 국민건강보험공단 표본코호트 DB)

  • Cho, Hyunjoo;Jung, Hyejin;Lim, Sabina
    • The Journal of Korean Medicine
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    • v.40 no.3
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    • pp.1-20
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    • 2019
  • Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

Effect of Handgrip Strength to Cognitive Impairment in Patients with Hypertension (고혈압 환자의 악력수준이 인지기능 저하에 미치는 영향)

  • Eun-Jung Bae;Il-Su Park
    • The Journal of Korean Society for School & Community Health Education
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    • v.24 no.4
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    • pp.27-37
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    • 2023
  • Objectives: The purpose of this study was to investigate the effect of handgrip strength level on cognitive impairment in hypertensive patients. Methods: This study used the first to eighth year data of the Korean Longitudinal Study of Aging (KLoSA). Of the 10,254 respondents who participated in the basic survey, respondents were included that they were diagnosed with high blood pressure and had no cognitive impairment. The handgrip strength was based on the highest value of handgrip strength for both hands. Cognitive function using MMSE results and 23 points or less were defined as cognitive impairment. Cox models were conducted to estimate the hazard ratios (HRs) of cognitive impairment in relation to handgrip strength adjusting for covariates. Results: In the case of hypertension patients, the probability of cognitive decline decreased by 3.0% every time the maximum handgrip strength increased by 1 unit. In the analysis by age, under the age of 64 had a 1.8% decrease in the probability of cognitive decline whenever the maximum handgrip strength increased by 1 unit, and a 3.6% decrease in those over the age of 65. In the gender analysis, male had a 3.2% decrease in the probability of cognitive decline for every 1 unit increase in the maximum handgrip strength, and female had a 2.6% decrease. Conclusions: The results of this study are expected to be used as basic data for the development of interventions to prevent cognitive decline in hypertensive patients by identifying the effect of handgrip strength level on cognitive decline. It is also expected to be used as basic data for health education on the necessity of increasing muscle strength for hypertension patients in the community.

Compliance with Health Behavior among Patients who are Hypertensive (고혈압 환자의 건강행위 이행)

  • Jeong Hye-Sun;Cho Ok-Hee;Yoo Yang-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.12 no.2
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    • pp.223-230
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    • 2005
  • Purpose: This study was done to investigate compliance with health behaviors among patients who are hypertensive. Method: The participants in this study were 121 outpatients with hypertension. Compliance with health behaviors was measured using a questionnaire developed by the researchers. Data were analyzed using t-test, ANOVA, Duncan's multiple range test and chi square test. Results: According to tile general characteristics of the participants, compliance with medication and diet was higher among women than men, among high school graduates than middle school graduates or those with lower academic qualifications, and among those who were unemployed compared to those who were employed. Compliance with alcohol abstinence or not smoking was higher among women than men, and among those who were unemployed compared to those who were employed. According to the risk factors of hypertension, compliance with health behaviors was significantly higher in those who had associated diseases. The participants in the group with a hypertension morbidity period longer than 10 years did exercise more than 3 times a week and regularly weighed themselves once or more a week. The item showing highest compliance concerning medication and diet was 'Take prescribed drugs regularly', while the one showing lowest was 'Take drugs with knowledge about their side effects'.

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A study on the Early Postoperative Hemodynamic Changes after Correction of Congenital Heart Defects associated with Pulmonary Hypertension (폐동맥고혈압증을 동반한 선천성 심기형 환아들에서 술후 조기 혈류역학적 변화에 대한 연구)

  • Kim, Yong-Jin;Kim, Gi-Bong
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.32-40
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    • 1990
  • Surgical correction of congenital cardiac defects in infants and children with an elevated pulmonary arterial pressure or pulmonary vascular resistance carries a significant early postoperative mortality. And accurate assessments of cardiac output is critically important in these patients. From April 1988 through September 1989, serial measurements of cardiac index, ratio of pulmonary-systemic systolic pressure, ratio of pulmonary-systemic resistance, central venous pressure, left atrial pressure, and urine output during the first 48 hours after the cardiac operation were made in 30 congenital cardiac defects associated with pulmonary hypertension. Cardiac index showed significant increase only after 24 hour postoperatively and this low cardiac performance in the early postoperative period should be considered when postoperative management is being planned in the risky patients. There were no variables which showed any significant correlation with cardiac index. In 12 cases[40%], pulmonary hypertensive crisis developed during the 48 hours postoperatively, and they were treated with full sedation, hyperventilation with 100 % 0y and pulmonary vasodilator infusion. In all patient with preoperative pulmonary hypertension, surgical placement of a pulmonary artery catheter is desirable to allow prompt diagnosis of pulmonary hypertensive crisis and to monitor subsequent therapy.

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Comparision of medical care utilization between newly detected hypertensive patients and known hypertensive patients (정기건강진단으로 밝혀진 고혈압환자의 의료이용에 관한 연구)

  • Cheon, Byung-Yool
    • 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.

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Endothelin-1 Levels in Patients with Heart Disease Associated with Pulmonary Hypertension ; Potential role of Endothelin-1 in genesis of pulmonary artery vasospasm (개심술 환자에서 술전및 술후의 폐동맥 고혈압및 혈역학적 변수들과 ET-1치와의 관계에 대한 연구)

  • 박형주
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.650-660
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    • 1992
  • To elucidate a potential contribution of endotheline-1[ET-1] to the genesis of pulmonary hypertension and postoperative pulmonary hypertensive crisis in the patients with heart disease, we measured plasma levels of the ET-1 during perioperative period of open heart surgery. In addition, we examined changes of ET-1 during perioperative period and correlations between ET-1 levels and hemodynamic variables. 12 patients including 5 acquired heart disease and 7 congenital heart disease patients were selected randomly as a study group, Group A and B, respectively. 6 patients proved not having heart or hemodynamic problem were selected as a control, Group C. 110 blood samples from pulmonary artery[ET-P] and radial artery[ET-S] were taken and assayed by Sep-pak extraction and RIA. ET-1 levels of Group A were ET-P, 3.94$\pm$5.31pg /ml, ET-S, 3.10$\pm$2.90pg/ml[p>0.05], Group B were ET-P, 1.63$\pm$0.62pg/ml, ET-S, 1.99$\pm$2.45pg/ml[p>0.05], Group C were ET-P, 1.97$\pm$2.02pg/ml, ET-S, 1.72$\pm$0.77pg/ml[p>0.05]. There were no statistically significant differences of ET-1 levels among the Group A, B, C[p>0.05]. There was no correlation between pulmonary artery pressure[PAP] and ET-1 level[p>0.05], and ET-1 levels were not increased even in the cases of pulmonary hypertensive criwis or low cardiac output syndrome, whereas significant correlation between ET-S and pulmonary vascular res-istance[Rp] [r=0.36, p<0.05], and negative correlation between ET-S and OS saturation of pulmonary artery[OS-P][r= -0.49, p<0.01] were identified. Another significant finding was peak increase of ET-1 levels in the postoperative period 1 hour[p<0.05] and then gra-dualy decrease through the postoperative period. In conclusion, ET-1 has no correlation with PAP, whereas correlation with Rp, and inverse correlation with OS-P. It is suggested that ET-1 is neither the direct causative substance of pulmonary hypertension nor pulmonary vasospasm but there must be increased production of ET-1 in chronic pulmonary hypertensive state. Counter-regulatory mechanism to ET-1 is speculated during the pulmonary vasospasm.

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Evaluation of Therapeutic Differences of Angiotensin II Receptor Blockers and Calcium Channel Blockers Among Hypertensive Patients Classified by Oriental Traditional Way (한국적 의학 기준에 근거한 고혈압환자의 Angiotensin II Receptor Blockers와 Calcium Channel Blockers의 약물 평가)

  • Lee, Ok Sang;Cheon, Young Ju;Ye, Kyong Nam;Yoon, Hee Young;Kim, Jung Tae;Lee, Yun Jeong;Lim, Sung Cil
    • YAKHAK HOEJI
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    • v.58 no.2
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    • pp.141-149
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    • 2014
  • Background: Oriental lifestyle for treating diseases has been developed and well-accepted for a long time among Koreans. Sasang Constitution theory, originated from Korean traditional medicine, suggests that medication treatment should be differentiated by each patient's body classification (So-yang [SY], So-eum [SE], Tae-yang [TY], and Tae-eum [TE]), in contrary to western medicine's theory that medication should be applied equally by disease indication without such classification. However, the pharmacotherapeutic outcomes of these theories have not been compared to date. In this study, we aimed to compare the two theories by evaluating blood pressure (BP), which is lowered as a therapeutic outcome, among hypertensive patients taking angiotensin II receptor blockers (ARBs) or calcium channel blockers (CCBs), two most commonly used antihypertensive classes in Korea. Methods: From April 2006 to June 2012, we retrospectively collected data on hypertensive patients with Sasang Constitution classification at Kyunghee University Hospital at Gangdong, one of the East-West collaborative medical centers in Korea. We collected information on age, gender, underlying diseases, antihypertensive drugs (ARB, CCB, ARB+CCB), and BP by reviewing the electronic medical records. We excluded patients with missing blood pressure at baseline or follow-up, or those who had a change in their antihypertensive drug class during follow-up. Results: We selected a total of 573 patients (SY: 165, SE: 158, TY: 0, TE: 250). Baseline BPs were on average 139.0/82.0 mmHg for SY, 137.8/78.5 mmHg for SE, and 138.7/79.2 mmHg for TE. In all three groups, CCBs were the most prescribed, followed by combination therapy with ARB+CCB, then ARBs. BP reduction after 1 month of initial medication was significantly different among the drug classes, but not in Sasang constitutional classification (ARB [SY: -12.4/-4.7, SE: -12.3/-2.5, TE: -8.6/-1.8], CCB [SY: -12.3/-5.4, SE: -13.0/-2.3, TE: -10.8/-6.0], ARB+CCB [SY: -15.6/-6.7, SE: -18.4/-8.1, TE: -20.2/-6.7], drug [$P{\leq}0.05$/P>0.05], constitutional type [P>0.05/P>0.05]). Conclusion: We observed significant differences in reduction of blood pressure by classes of drugs (ARB+CCB>CCB>ARB) but not by Sasang constitutional classification. Therefore, current approach of antihypertensive pharmacotherapy assisted by Western medicine is appropriate for treatment of hypertension. However, further larger scale or prospective studies are required in order to confirm these results.