The target of the study was to identify patients living with Compound high blood pressure and describe the epidemiological, treatment and progressive aspects. We had realized retrospective and descriptive study comple...The target of the study was to identify patients living with Compound high blood pressure and describe the epidemiological, treatment and progressive aspects. We had realized retrospective and descriptive study completed throughout twelve months from 1st January to December 31, 2011. The study took into account 250 hypertensives known or not admitted in the cardiology and medical intensive care units at the Sylvanus Olympio Teaching Hospital in Lomé. In total, the frequency of complications of the High Blood Pressure was 33.3% with a male predominance. Patients’ average age was 52.4 years. The most frequent reasons of admission were coma (32%) and hypertensive eruption (28%). The excessive consumption of salt and alcohol were other dominant modifiable risks factors with respectively 36.8% and 22.8%. Neurologic complications were the most frequent of cerebrovascular accidents (CVA) (66%) among which strokes represented 69.7%. Cardiac complications came in second position (31.2%). Double treatment was optional in 62.2% cases with IEC+ Ica++ associated. In 56.6% cases patients with renal disease in terminal stage had been dialysed. The level of total lethality was 34%. The main cause of death was CVA (cerebrovascular accidents) (85.9%). High Blood Pressure is then a very plague with regard to its complications. Its effective caretaking is nothing but through primary prevention based on sensitization, education of the entire grass-roots and it requires the mobilization of all social components.展开更多
Objective: To study hypertension and its manifestations in?Out-patients’ Department of Cardiology of Kati. Methods: The study was traversal and it was based on a sample of 300 patients, reached during the interval of...Objective: To study hypertension and its manifestations in?Out-patients’ Department of Cardiology of Kati. Methods: The study was traversal and it was based on a sample of 300 patients, reached during the interval of 12 (twelve) months (from June 2012 to June 2013). Results: The predominance was among the females with 68.7%. The average age was about?55.8 ± 12.2 years old. The extreme ages were?about 21 and 90 years?old. In the set,?66% of the patients lived in the town of Kati.?The symptoms of Dieulafoy were predominantly the reasons for consultation with 55.7%. The cardiac frequency in the vast majority of cases was normal (85.3%). The left ventricular hypertrophy in the electrocardiogram was observed in more than half of the cases,?that is to say,?51.3%. In a bit higher proportion,?the echocardiography Doppler became normal,?that is to say,?54%. Brain scanner done on 9 patients found out signs of cerebrovascular stroke in 8 patients,?that is to say,?a frequency of 88.9%. In 76% of cases?of orthostatic hypotension,?the patients were hypertensive.?The blood pressure was normal during the passage of orthostatism in the cases of 258 of our patients,?that is to say,?86.0% of the cases. However, the orthostatic hypotension (OH) was observed in the cases of 42 patients, that is to say,?14.0% of the cases. In this set of patients,?41.6% of the moans were due to cephalgias and dizziness’s. The monotherapy of patients with OH represented 47.6% of the cases. Blood pressure was not controlled in 66.7% of the?cases of?OH. The biological examinations required were normal in 52.4% of the cases. Conclusion: The hypertension is a disease which is frequently the reason for consultation in cardiology. The symptoms of Dieulafoy can be the signs of call. The complications are sometimes recurrent. The orthostatic hypotension should be found out even under monotherapy on a balanced or non-balanced hypertensive patient through treatment.展开更多
Objective： Hypertension is an important risk factor of cardiovascular disease and increases mortality in the elderly. However, the available medical evidences are both inconsistent and insufficient regarding establis...Objective： Hypertension is an important risk factor of cardiovascular disease and increases mortality in the elderly. However, the available medical evidences are both inconsistent and insufficient regarding establishing credible and useful blood pressure （BP） targets in the hypertensive elderly. This review summarizes the existing evidences used for establishing optimal BP targets for this patient population and points out some data inconsistencies which have added to the uncertainty. Data Sources： We conducted a search for the articles published in English in the PubMed database up to March 2017, with the keywords ＂hypertension,＂ ＂elderly,＂ ＂blood pressure,＂ and ＂antihypertensive.＂ Study Selection： Articles that related to BP targeting in the hypertensive elderly were selected for this review. Results： The selected studies indicated that antihypertensive therapy can substantially reduce the risk of cardiovascular events and mortality, for a subset of the elderly （60 years or older） with systolic BP 〉 160 mmHg. Studies regarding more strict targets yielded mixed findings. For the very old and frail patients （80 years or older）, there is a lack of evidence that optimal BP targets and intensive antihypertensives are helpful but in fact may be harmful. Conclusions： There are solid evidences that patients who are 60-80 years old and in good health have benefited from lowering their BP to below 150/90 mmHg. If well tolerated, the BP target can be further lowered to below 140/90 mmHg. However, for the very old and frail, individualized and careful assessment is crucial. Antihypertensive treatment should be cautious and the adverse effect of drugs requires close monitoring as such treatment can be counterproductive.展开更多
Antihypertensive medication is one way to manage hypertension but many hypertensive patients do not optimize drug therapy to achieve blood pressure control. Hypertensive medication non-adherence continues to become a ...Antihypertensive medication is one way to manage hypertension but many hypertensive patients do not optimize drug therapy to achieve blood pressure control. Hypertensive medication non-adherence continues to become a contributing factor to hypertensive complications like heart attacks, heart failure, stroke, kidney disease. Prevalence of non-adherence to antihypertensive treatment is not known but it’s thought to be increasing. Associated factors of non-adherence are complex, are both internal and external to the patient but are difficult to extrapolate. This can partly be because the determinants of non-adherence to hypertensive may have a locality effect due to many factors such as culture and health system in a given locality. Hence, studies from one region may not have a cross-application. Therefore, there is the need to study the factors associated with non-adherence at a local scale. Descriptive study design was adopted to guide the implementation of the study. The population comprised of 575 people among doctors, pharmacists, nurses, record officers and hypertension patients. The respondents were identified through simple random sampling and a sample size of 81 patients was achieved and 10 health care providers including doctors, pharmacists, record officers and nurses were also interviewed through census method. Data was collected between the month of April and May 2019. Questionnaires were used as data collection tools for the patients while the interview schedule was conducted to health care providers through an interview guide. Descriptive and inferential statistics were used for data analysis, aided by SPSS. The study revealed a significant negative correlation (rpb = −0.227, p 0.05) between age and non-adherent, insignificant relationship with marital status (rpb = −0.129), insignificant (rpb = −0.064) correlation with patients’ level of education and a positive correlation with monthly income (rpb = 0.24). A majority of patients stated that (64%) of the hypertensive patients had missed medication. Patient-related factors: cost of medication, religious beliefs, age of the patient, their education level, preference to traditional medicine, and sociocultural factors together were found to be significant predictors of non-adherence to hypertension medication, χ2= 17.14, df = 1, N = 81, p 0.05. However, it’s only age (p = 0.01), religious beliefs (p = 0.04), and cost of medication (p 0.05) that were individually, significant predictors to non-adherence. Non-adherence to hypertension medication is a major problem at Chuka Level Five Hospital. This was due to lack of funds, time, forgetfulness and patient thinking that they had healed thus continuous follow-ups to improve adherence, positive reinforcement to increase motivation in order to address forgetfulness, and supply of constant and subsidized hypertensive drugs to the hospital are necessary to prevent patients from missing the drugs. There is need to reduce out of pocket payment through establishment and strengthening of the community health insurance scheme. The study recommends that the hospital should set aside some resources for making patients’ follow-ups especially those were treated and left to go home;discussions be made with patients on severity of non-adherence and importance of adherence;use of positive reinforcement to increase motivation and mechanism to be put in place to subsidize the cost of medication.展开更多
<b>Background: </b>Non-adherence to hypertensive medication continues to become a contributing factor to hypertensive complications like stroke, heart attacks, kidney disease heart failure. Associated fact...<b>Background: </b>Non-adherence to hypertensive medication continues to become a contributing factor to hypertensive complications like stroke, heart attacks, kidney disease heart failure. Associated factors to non-adherence are complex, are both internal and external to the patient and are difficult to extrapolate. Reports from Chuka referral hospital records showed that in 2016 there were 140 patients with hypertensive complications from 560 patients who attended the medical clinic that year. <b>Objective:</b> This study sought to explore the patient’s related factors that are associated with non-adherence to hypertension medication. <b>Methods:</b> This is a descriptive study design of (N = 575) people among them doctors, pharmacists, nurses, record officers and hypertension patients. Simple random sampling for patients (n = 81) and census sampling for health care workers was done and data collected using questionnaires and interview schedules between April 4<sup>th</sup>-May 30<sup>th</sup> 2019. Inferential and descriptive statistics were used for data analysis, aided by SPSS version 25. <b>Results:</b> 64% of the patients stated that they had missed medication. A significant negative correlation (<i>r<sub>pb</sub></i> = -0.23, <i>p</i> < 0.05) between age and non-adherence, significant positive correlation with monthly income (<i>r<sub>pb</sub></i> = 0.24, <i>p</i> < 0.04), non-significant relationship between non-adherence and marital status (<i>r<sub>pb</sub></i> = -0.13, <i>p</i> = 0.25) and patients’ level of education (<i>r<sub>pb</sub></i> = -0.06, <i>p</i> = 0.57). The overall model of health system related factors were found to be significant (<i>p</i><i> </i>< 0.05) and this included;quality of health service, physician patient relationship, stock out, health education, and availability of medicine (<i>p = </i>0.012). <b>Conclusion:</b><i> </i>Lacks of funds, unavailability of drugs are the leading factors to regimen completion. This could be easily be addressed by the government.展开更多
文摘The target of the study was to identify patients living with Compound high blood pressure and describe the epidemiological, treatment and progressive aspects. We had realized retrospective and descriptive study completed throughout twelve months from 1st January to December 31, 2011. The study took into account 250 hypertensives known or not admitted in the cardiology and medical intensive care units at the Sylvanus Olympio Teaching Hospital in Lomé. In total, the frequency of complications of the High Blood Pressure was 33.3% with a male predominance. Patients’ average age was 52.4 years. The most frequent reasons of admission were coma (32%) and hypertensive eruption (28%). The excessive consumption of salt and alcohol were other dominant modifiable risks factors with respectively 36.8% and 22.8%. Neurologic complications were the most frequent of cerebrovascular accidents (CVA) (66%) among which strokes represented 69.7%. Cardiac complications came in second position (31.2%). Double treatment was optional in 62.2% cases with IEC+ Ica++ associated. In 56.6% cases patients with renal disease in terminal stage had been dialysed. The level of total lethality was 34%. The main cause of death was CVA (cerebrovascular accidents) (85.9%). High Blood Pressure is then a very plague with regard to its complications. Its effective caretaking is nothing but through primary prevention based on sensitization, education of the entire grass-roots and it requires the mobilization of all social components.
文摘Objective: To study hypertension and its manifestations in?Out-patients’ Department of Cardiology of Kati. Methods: The study was traversal and it was based on a sample of 300 patients, reached during the interval of 12 (twelve) months (from June 2012 to June 2013). Results: The predominance was among the females with 68.7%. The average age was about?55.8 ± 12.2 years old. The extreme ages were?about 21 and 90 years?old. In the set,?66% of the patients lived in the town of Kati.?The symptoms of Dieulafoy were predominantly the reasons for consultation with 55.7%. The cardiac frequency in the vast majority of cases was normal (85.3%). The left ventricular hypertrophy in the electrocardiogram was observed in more than half of the cases,?that is to say,?51.3%. In a bit higher proportion,?the echocardiography Doppler became normal,?that is to say,?54%. Brain scanner done on 9 patients found out signs of cerebrovascular stroke in 8 patients,?that is to say,?a frequency of 88.9%. In 76% of cases?of orthostatic hypotension,?the patients were hypertensive.?The blood pressure was normal during the passage of orthostatism in the cases of 258 of our patients,?that is to say,?86.0% of the cases. However, the orthostatic hypotension (OH) was observed in the cases of 42 patients, that is to say,?14.0% of the cases. In this set of patients,?41.6% of the moans were due to cephalgias and dizziness’s. The monotherapy of patients with OH represented 47.6% of the cases. Blood pressure was not controlled in 66.7% of the?cases of?OH. The biological examinations required were normal in 52.4% of the cases. Conclusion: The hypertension is a disease which is frequently the reason for consultation in cardiology. The symptoms of Dieulafoy can be the signs of call. The complications are sometimes recurrent. The orthostatic hypotension should be found out even under monotherapy on a balanced or non-balanced hypertensive patient through treatment.
文摘Objective： Hypertension is an important risk factor of cardiovascular disease and increases mortality in the elderly. However, the available medical evidences are both inconsistent and insufficient regarding establishing credible and useful blood pressure （BP） targets in the hypertensive elderly. This review summarizes the existing evidences used for establishing optimal BP targets for this patient population and points out some data inconsistencies which have added to the uncertainty. Data Sources： We conducted a search for the articles published in English in the PubMed database up to March 2017, with the keywords ＂hypertension,＂ ＂elderly,＂ ＂blood pressure,＂ and ＂antihypertensive.＂ Study Selection： Articles that related to BP targeting in the hypertensive elderly were selected for this review. Results： The selected studies indicated that antihypertensive therapy can substantially reduce the risk of cardiovascular events and mortality, for a subset of the elderly （60 years or older） with systolic BP 〉 160 mmHg. Studies regarding more strict targets yielded mixed findings. For the very old and frail patients （80 years or older）, there is a lack of evidence that optimal BP targets and intensive antihypertensives are helpful but in fact may be harmful. Conclusions： There are solid evidences that patients who are 60-80 years old and in good health have benefited from lowering their BP to below 150/90 mmHg. If well tolerated, the BP target can be further lowered to below 140/90 mmHg. However, for the very old and frail, individualized and careful assessment is crucial. Antihypertensive treatment should be cautious and the adverse effect of drugs requires close monitoring as such treatment can be counterproductive.
文摘Antihypertensive medication is one way to manage hypertension but many hypertensive patients do not optimize drug therapy to achieve blood pressure control. Hypertensive medication non-adherence continues to become a contributing factor to hypertensive complications like heart attacks, heart failure, stroke, kidney disease. Prevalence of non-adherence to antihypertensive treatment is not known but it’s thought to be increasing. Associated factors of non-adherence are complex, are both internal and external to the patient but are difficult to extrapolate. This can partly be because the determinants of non-adherence to hypertensive may have a locality effect due to many factors such as culture and health system in a given locality. Hence, studies from one region may not have a cross-application. Therefore, there is the need to study the factors associated with non-adherence at a local scale. Descriptive study design was adopted to guide the implementation of the study. The population comprised of 575 people among doctors, pharmacists, nurses, record officers and hypertension patients. The respondents were identified through simple random sampling and a sample size of 81 patients was achieved and 10 health care providers including doctors, pharmacists, record officers and nurses were also interviewed through census method. Data was collected between the month of April and May 2019. Questionnaires were used as data collection tools for the patients while the interview schedule was conducted to health care providers through an interview guide. Descriptive and inferential statistics were used for data analysis, aided by SPSS. The study revealed a significant negative correlation (rpb = −0.227, p 0.05) between age and non-adherent, insignificant relationship with marital status (rpb = −0.129), insignificant (rpb = −0.064) correlation with patients’ level of education and a positive correlation with monthly income (rpb = 0.24). A majority of patients stated that (64%) of the hypertensive patients had missed medication. Patient-related factors: cost of medication, religious beliefs, age of the patient, their education level, preference to traditional medicine, and sociocultural factors together were found to be significant predictors of non-adherence to hypertension medication, χ2= 17.14, df = 1, N = 81, p 0.05. However, it’s only age (p = 0.01), religious beliefs (p = 0.04), and cost of medication (p 0.05) that were individually, significant predictors to non-adherence. Non-adherence to hypertension medication is a major problem at Chuka Level Five Hospital. This was due to lack of funds, time, forgetfulness and patient thinking that they had healed thus continuous follow-ups to improve adherence, positive reinforcement to increase motivation in order to address forgetfulness, and supply of constant and subsidized hypertensive drugs to the hospital are necessary to prevent patients from missing the drugs. There is need to reduce out of pocket payment through establishment and strengthening of the community health insurance scheme. The study recommends that the hospital should set aside some resources for making patients’ follow-ups especially those were treated and left to go home;discussions be made with patients on severity of non-adherence and importance of adherence;use of positive reinforcement to increase motivation and mechanism to be put in place to subsidize the cost of medication.
文摘<b>Background: </b>Non-adherence to hypertensive medication continues to become a contributing factor to hypertensive complications like stroke, heart attacks, kidney disease heart failure. Associated factors to non-adherence are complex, are both internal and external to the patient and are difficult to extrapolate. Reports from Chuka referral hospital records showed that in 2016 there were 140 patients with hypertensive complications from 560 patients who attended the medical clinic that year. <b>Objective:</b> This study sought to explore the patient’s related factors that are associated with non-adherence to hypertension medication. <b>Methods:</b> This is a descriptive study design of (N = 575) people among them doctors, pharmacists, nurses, record officers and hypertension patients. Simple random sampling for patients (n = 81) and census sampling for health care workers was done and data collected using questionnaires and interview schedules between April 4<sup>th</sup>-May 30<sup>th</sup> 2019. Inferential and descriptive statistics were used for data analysis, aided by SPSS version 25. <b>Results:</b> 64% of the patients stated that they had missed medication. A significant negative correlation (<i>r<sub>pb</sub></i> = -0.23, <i>p</i> < 0.05) between age and non-adherence, significant positive correlation with monthly income (<i>r<sub>pb</sub></i> = 0.24, <i>p</i> < 0.04), non-significant relationship between non-adherence and marital status (<i>r<sub>pb</sub></i> = -0.13, <i>p</i> = 0.25) and patients’ level of education (<i>r<sub>pb</sub></i> = -0.06, <i>p</i> = 0.57). The overall model of health system related factors were found to be significant (<i>p</i><i> </i>< 0.05) and this included;quality of health service, physician patient relationship, stock out, health education, and availability of medicine (<i>p = </i>0.012). <b>Conclusion:</b><i> </i>Lacks of funds, unavailability of drugs are the leading factors to regimen completion. This could be easily be addressed by the government.
