Dear editor, We read with pleasure the well-designed study by Butler et al of electrical cardioversion of emergency department patients with atrial fibrillation. We appreciate their analysis of the distinctives of pro...Dear editor, We read with pleasure the well-designed study by Butler et al of electrical cardioversion of emergency department patients with atrial fibrillation. We appreciate their analysis of the distinctives of procedural sedation when employed for this indication. Understanding the dosing adjustments to propofol undertaken by their sedationists will help us more carefully evaluate our own approach to sedating patients undergoing electrical cardioversion of atrial fibrillation.展开更多
Objective To explore the current status of morning blood pressure control and associated risk factors among treated hypertensives,and toprovide useful information for morning blood pressure control.Methods We consecut...Objective To explore the current status of morning blood pressure control and associated risk factors among treated hypertensives,and toprovide useful information for morning blood pressure control.Methods We consecutively enrolled a total of 1307 treated hypertensive patients from Fuwai Hospital during May 2014 to September 2017.展开更多
High blood pressure (HBP) is a health problem world—wide. In Togo, that affection constitutes a more and more pre-occupying cause of morbidity and mortality. This study is a prospective one which intended to identify...High blood pressure (HBP) is a health problem world—wide. In Togo, that affection constitutes a more and more pre-occupying cause of morbidity and mortality. This study is a prospective one which intended to identify the antihypertensive regimens prescribed and evaluate their effect on patients’ blood pressure (BP) control. Out of the 204 patients enrolled (mean: 55.01 ± 12.55 years;sex ratio: 1.3), 112/176 placed on antihypertensive therapy have controlled their BP (38.39% outpatients vs 61.61% inpatients). Related to the sex factor, we didn’t observe any significant difference in the BP control. Whereas, the mean median value of BP reduction of outpatients (30.00/15.00 mmHg) (p = 0.001) was half lower than that of inpatients (60.00/30.00 mmHg (p = 0.004)). Thirty five outpatients (81.40%) vs 64 inpatients (92.75%) were placed on combination therapy. The bitherapy was prescribed to 23 outpatients (53.49%) against 27 inpatients (39.13%) while the quadritherapy and more than 4 drugs combination were prescribed exclusively to inpatients (20.29%, n = 14). That quadritherapy induced a significant mean reduction of inpatients’ SBP compared to monotherapy (p = 0.043) and to bitherapy (p = 0.004). The favorite combinations were D + CCA, D + ACEI, D + CCA + ACEI and D + CCA + ACEI + CAAD of which the quadruple therapy showed a significant inpatients’ DBP control (p = 0.015) compared to D + CCA combination. The combinations including at least one diuretic induced a significant difference between outpatients (median value: 30.000/10.000 mmHg) (p < 0.001) and inpatients (median value: 60.000 mmHg/30 mmHg) (p < 0.001). The first-line molecules and fixe combinations prescribed in decreasing frequency were among others: hydrochlorothiazide + captopril, nicardipine, α methyldopa for outpatients;furosemide, nicardipine, captopril, α methyldopa, hydrochlorothiazide + captopril for inpatients. Diuretics, CCAs and ACEIs were the 3 favorite pharmacological groups for essential hypertension management in our African resource limited context. Combined to CAAD, they represented the best quadruple combination among inpatients having showed a significant difference in DBP control compared to D + CCA combination.展开更多
Objective: We explored the relationship between traditional Chinese constitution and risk factors for cardiovascular disease in subjects with high-normal blood pressure (BP). Methods: The traditional Chinese constitut...Objective: We explored the relationship between traditional Chinese constitution and risk factors for cardiovascular disease in subjects with high-normal blood pressure (BP). Methods: The traditional Chinese constitution of 80 subjects with high-normal BP was judged by questionnaires and interviews. Measurements of cardiovascular and metabolic health in- cluded BP, body weight, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), 2-hour oral glucose tolerance test (OGTT2h), and waist cir- cumference. Statistical relationships between cardiovascular disease risk factors and specific Chinese constitution were evaluated by univariate and multivariate analyses. Results: Ping He, Tan Shi, and Yin Xu were the dominant constitutions in subjects with high-normal blood pressure. There were significant differences in weight, LDL-C, BMI, OGTT2h, and waist circumference between Tan Shi and Ping He (P P < 0.05), and weight, BMI, waist circumference, SBP, and LDL-C between Tan Shi and Yin Xu constitutions (P < 0.01). Logistic regression found a strong association between the Tan Shi constitution and LDL-C in subjects with high-normal blood pressure. Conclusion: Ping He, Tan Shi, and Yin Xu are the principle traditional Chinese constitutions in subject with high-normal blood pressure. The Tan Shi constitution is associated with multiple risk factors for cardiovascular disease (LDL-C, BMI, body weight, and waist circumference), while OGTT2h is closely related to the Yin Xu constitution.展开更多
Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determin...Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.展开更多
An inflatable cuff wrapped around the upper arm is widely used in noninvasive blood pressure measurement.However, the mechanical interaction between cuff and arm tissues, a factor that potentially affects the accuracy...An inflatable cuff wrapped around the upper arm is widely used in noninvasive blood pressure measurement.However, the mechanical interaction between cuff and arm tissues, a factor that potentially affects the accuracy of noninvasive blood pressure measurement, remains rarely addressed. In the present study, finite element（FE） models were constructed to quantify intra-arm stresses generated by cuff compression, aiming to provide some theoretical evidence for identifying factors of importance for blood pressure measurement or explaining clinical observations. Obtained results showed that the simulated tissue stresses were highly sensitive to the distribution of cuff pressure on the arm surface and the contact condition between muscle and bone. In contrast, the magnitude of cuff pressure and small variations in elastic properties of arm soft tissues had little influence on the efficiency of pressure transmission in arm tissues. In particular, it was found that a thickened subcutaneous fat layer in obese subjects significantly reduced the effective pressure transmitted to the brachial artery, which may explain why blood pressure overestimation occurs more frequently in obese subjects in noninvasive blood pressure measurement.展开更多
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
Purpose: To investigate the distribution of population and syndrome patterns in high-normal blood pressure people in Hebei area. Methods: A total of 453 people who met the inclusion criteria were investigated using a ...Purpose: To investigate the distribution of population and syndrome patterns in high-normal blood pressure people in Hebei area. Methods: A total of 453 people who met the inclusion criteria were investigated using a high-normal blood pressure human mass survey questionnaire. Results: of the 453 constitution types of high-normal blood pressure patients in Hebei area, 184 were the constitution of yin-yang harmony, accounting for 40.62% of the total;73 were the constitution of yang asthenia, accounting for 16.11% of the total;59 were the constitution of damp-heat, accounting for 13.02% of the total;52 were the constitution of qi asthenia, accounting for 11.48% of the total;8 were the allergic constitution, accounting for 1.77% of the total. In addition, of their syndrome types, the syndrome of liver-fire hyperactivity were accounting for 30.24%;the syndrome of excessive phlegm-dampness were accounting for 26.71%;the syndrome of yin-deficiency and yang-predominance were accounting for 23.18%;the syndrome of deficiency of both yin and yang were accounting for 19.87%. Conclusion: Among the high-normal blood pressure people in Hebei area, the proportion of the constitution of yin-yang harmony is the highest, followed by the constitution of yang asthenia, the constitution of damp-heat, and the constitution of qi asthenia, with the lowest percentage being the allergic constitution. In addition, when it comes to the syndrome of them, the proportion of the syndrome of liver-fire hyperactivity is the highest, followed by the syndrome of yin-deficiency and yang-predominance, and the lowest is the syndrome of deficiency of both yin and yang.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
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
Isoptin SR was used in 65 essential hypertensive patients.240mg Isoptin SR(German Knoll Pharmaceutical company) Per day was used in group A(35 cases)for 6 weeks,and in guoup B(30 cases)for 24 weeks,BP in group a and B...Isoptin SR was used in 65 essential hypertensive patients.240mg Isoptin SR(German Knoll Pharmaceutical company) Per day was used in group A(35 cases)for 6 weeks,and in guoup B(30 cases)for 24 weeks,BP in group a and B decreased obviously in the first and second week after treament.展开更多
Objective To investigate the impacts of blood pressure control on coronary flow reserve(CFR)in hypertensive patients.Methods A total of 236 patients without significant coronary stenosis(defined as<50%luminal narro...Objective To investigate the impacts of blood pressure control on coronary flow reserve(CFR)in hypertensive patients.Methods A total of 236 patients without significant coronary stenosis(defined as<50%luminal narrowing confirmed by coronary angiography or coronary artery CT scan)between January 2011 and July 2015were retrospectively enrolled in this study.CFR展开更多
Objective To observe the clinical effects of acupuncture method of'Huoxue Sanfeng,Shugan Jianpi'(activating blood and eliminating wind,soothing liver and strengthening spleen)on morning blood pressure in patie...Objective To observe the clinical effects of acupuncture method of'Huoxue Sanfeng,Shugan Jianpi'(activating blood and eliminating wind,soothing liver and strengthening spleen)on morning blood pressure in patients with cerebral infarction combined with essential hypertension.Methods Sixty-eight patients were randomly divided into an observation group and a control group,34 cases in each one.The patients in the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
文摘Dear editor, We read with pleasure the well-designed study by Butler et al of electrical cardioversion of emergency department patients with atrial fibrillation. We appreciate their analysis of the distinctives of procedural sedation when employed for this indication. Understanding the dosing adjustments to propofol undertaken by their sedationists will help us more carefully evaluate our own approach to sedating patients undergoing electrical cardioversion of atrial fibrillation.
文摘Objective To explore the current status of morning blood pressure control and associated risk factors among treated hypertensives,and toprovide useful information for morning blood pressure control.Methods We consecutively enrolled a total of 1307 treated hypertensive patients from Fuwai Hospital during May 2014 to September 2017.
文摘High blood pressure (HBP) is a health problem world—wide. In Togo, that affection constitutes a more and more pre-occupying cause of morbidity and mortality. This study is a prospective one which intended to identify the antihypertensive regimens prescribed and evaluate their effect on patients’ blood pressure (BP) control. Out of the 204 patients enrolled (mean: 55.01 ± 12.55 years;sex ratio: 1.3), 112/176 placed on antihypertensive therapy have controlled their BP (38.39% outpatients vs 61.61% inpatients). Related to the sex factor, we didn’t observe any significant difference in the BP control. Whereas, the mean median value of BP reduction of outpatients (30.00/15.00 mmHg) (p = 0.001) was half lower than that of inpatients (60.00/30.00 mmHg (p = 0.004)). Thirty five outpatients (81.40%) vs 64 inpatients (92.75%) were placed on combination therapy. The bitherapy was prescribed to 23 outpatients (53.49%) against 27 inpatients (39.13%) while the quadritherapy and more than 4 drugs combination were prescribed exclusively to inpatients (20.29%, n = 14). That quadritherapy induced a significant mean reduction of inpatients’ SBP compared to monotherapy (p = 0.043) and to bitherapy (p = 0.004). The favorite combinations were D + CCA, D + ACEI, D + CCA + ACEI and D + CCA + ACEI + CAAD of which the quadruple therapy showed a significant inpatients’ DBP control (p = 0.015) compared to D + CCA combination. The combinations including at least one diuretic induced a significant difference between outpatients (median value: 30.000/10.000 mmHg) (p < 0.001) and inpatients (median value: 60.000 mmHg/30 mmHg) (p < 0.001). The first-line molecules and fixe combinations prescribed in decreasing frequency were among others: hydrochlorothiazide + captopril, nicardipine, α methyldopa for outpatients;furosemide, nicardipine, captopril, α methyldopa, hydrochlorothiazide + captopril for inpatients. Diuretics, CCAs and ACEIs were the 3 favorite pharmacological groups for essential hypertension management in our African resource limited context. Combined to CAAD, they represented the best quadruple combination among inpatients having showed a significant difference in DBP control compared to D + CCA combination.
文摘Objective: We explored the relationship between traditional Chinese constitution and risk factors for cardiovascular disease in subjects with high-normal blood pressure (BP). Methods: The traditional Chinese constitution of 80 subjects with high-normal BP was judged by questionnaires and interviews. Measurements of cardiovascular and metabolic health in- cluded BP, body weight, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), 2-hour oral glucose tolerance test (OGTT2h), and waist cir- cumference. Statistical relationships between cardiovascular disease risk factors and specific Chinese constitution were evaluated by univariate and multivariate analyses. Results: Ping He, Tan Shi, and Yin Xu were the dominant constitutions in subjects with high-normal blood pressure. There were significant differences in weight, LDL-C, BMI, OGTT2h, and waist circumference between Tan Shi and Ping He (P P < 0.05), and weight, BMI, waist circumference, SBP, and LDL-C between Tan Shi and Yin Xu constitutions (P < 0.01). Logistic regression found a strong association between the Tan Shi constitution and LDL-C in subjects with high-normal blood pressure. Conclusion: Ping He, Tan Shi, and Yin Xu are the principle traditional Chinese constitutions in subject with high-normal blood pressure. The Tan Shi constitution is associated with multiple risk factors for cardiovascular disease (LDL-C, BMI, body weight, and waist circumference), while OGTT2h is closely related to the Yin Xu constitution.
文摘Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.
基金supported in part by the National Natural Science Foundation of China (Grant 81370438)the SJTU Medical-Engineering Cross-cutting Research Project (Grant YG2015MS53)supported by the Hui-Chun Chin and Tsung-Dao Lee Chinese Undergraduate Research Program Endowment
文摘An inflatable cuff wrapped around the upper arm is widely used in noninvasive blood pressure measurement.However, the mechanical interaction between cuff and arm tissues, a factor that potentially affects the accuracy of noninvasive blood pressure measurement, remains rarely addressed. In the present study, finite element（FE） models were constructed to quantify intra-arm stresses generated by cuff compression, aiming to provide some theoretical evidence for identifying factors of importance for blood pressure measurement or explaining clinical observations. Obtained results showed that the simulated tissue stresses were highly sensitive to the distribution of cuff pressure on the arm surface and the contact condition between muscle and bone. In contrast, the magnitude of cuff pressure and small variations in elastic properties of arm soft tissues had little influence on the efficiency of pressure transmission in arm tissues. In particular, it was found that a thickened subcutaneous fat layer in obese subjects significantly reduced the effective pressure transmitted to the brachial artery, which may explain why blood pressure overestimation occurs more frequently in obese subjects in noninvasive blood pressure measurement.
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Purpose: To investigate the distribution of population and syndrome patterns in high-normal blood pressure people in Hebei area. Methods: A total of 453 people who met the inclusion criteria were investigated using a high-normal blood pressure human mass survey questionnaire. Results: of the 453 constitution types of high-normal blood pressure patients in Hebei area, 184 were the constitution of yin-yang harmony, accounting for 40.62% of the total;73 were the constitution of yang asthenia, accounting for 16.11% of the total;59 were the constitution of damp-heat, accounting for 13.02% of the total;52 were the constitution of qi asthenia, accounting for 11.48% of the total;8 were the allergic constitution, accounting for 1.77% of the total. In addition, of their syndrome types, the syndrome of liver-fire hyperactivity were accounting for 30.24%;the syndrome of excessive phlegm-dampness were accounting for 26.71%;the syndrome of yin-deficiency and yang-predominance were accounting for 23.18%;the syndrome of deficiency of both yin and yang were accounting for 19.87%. Conclusion: Among the high-normal blood pressure people in Hebei area, the proportion of the constitution of yin-yang harmony is the highest, followed by the constitution of yang asthenia, the constitution of damp-heat, and the constitution of qi asthenia, with the lowest percentage being the allergic constitution. In addition, when it comes to the syndrome of them, the proportion of the syndrome of liver-fire hyperactivity is the highest, followed by the syndrome of yin-deficiency and yang-predominance, and the lowest is the syndrome of deficiency of both yin and yang.
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.
文摘Isoptin SR was used in 65 essential hypertensive patients.240mg Isoptin SR(German Knoll Pharmaceutical company) Per day was used in group A(35 cases)for 6 weeks,and in guoup B(30 cases)for 24 weeks,BP in group a and B decreased obviously in the first and second week after treament.
文摘Objective To investigate the impacts of blood pressure control on coronary flow reserve(CFR)in hypertensive patients.Methods A total of 236 patients without significant coronary stenosis(defined as<50%luminal narrowing confirmed by coronary angiography or coronary artery CT scan)between January 2011 and July 2015were retrospectively enrolled in this study.CFR
文摘Objective To observe the clinical effects of acupuncture method of'Huoxue Sanfeng,Shugan Jianpi'(activating blood and eliminating wind,soothing liver and strengthening spleen)on morning blood pressure in patients with cerebral infarction combined with essential hypertension.Methods Sixty-eight patients were randomly divided into an observation group and a control group,34 cases in each one.The patients in the
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.
