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Factors Associated with Early Postoperative Results of Total Anomalous Pulmonary Venous Connection Repair: Findings from Retrospective Single-Institution Data in Vietnam. 与全异常肺静脉连接修复术后早期结果相关的因素:来自越南单一机构回顾性数据的发现。
IF 2.2 Q2 Medicine Pub Date : 2021-06-01 eCollection Date: 2021-01-01 DOI: 10.2147/IBPC.S308778
Doan Quoc Hung, Dinh Xuan Huy, Hoang-Long Vo, Nguyen Sinh Hien

Introduction: There are scanty reports of the risk factors for pulmonary hypertensive crisis and low cardiac output syndrome after the operative repair of total anomalous pulmonary venous connection (TAPVC). We aim to evaluate early surgical outcomes of TAPVC and risk factors for pulmonary hypertensive crisis and low cardiac output syndrome.

Methods: We conducted a retrospective medical record review for all patients undergoing operative repair of TAPVC within 5 years. Outcome variables included pulmonary hypertensive crisis, low cardiac output syndrome and early mortality.

Results: Of 58 patients, we documented 77.59% supracardiac, 20.69% cardiac and 1.72% mixed site of connection. About 86.21% patients underwent elective surgery, and 13.79% patients required emergency surgery. Incidence rates were 27.59% for pulmonary hypertensive crisis and 6.90% for low cardiac output syndrome. Body weight below 6 kg, pneumonia, tachycardia, hepatomegaly, preoperative pulmonary congestion on chest x-ray, preoperative elevated mean pulmonary artery pressure, preoperative pulmonary venous obstruction, emergency surgery and prolonged aortic cross-clamping time were significant risk factors for postoperative pulmonary hypertensive crisis. Significant risk factors for postoperative low cardiac output syndrome included pneumonia, prolonged duration of preoperative mechanical ventilation and prolonged aortic cross-clamping time.

Conclusion: The early outcome of surgical repair of TAPVC was acceptable, with 96.55% survival rate. This current analysis suggests that a thorough evaluation of all preoperative and operative characteristics is imperative to achieve best medical and surgical outcomes.

前言:手术修复全异常肺静脉连接(TAPVC)后发生肺动脉高压危象和低心输出量综合征的危险因素报道较少。我们的目的是评估肺动脉高压危象和低心输出量综合征的早期手术结果和危险因素。方法:我们对5年内所有接受TAPVC手术修复的患者进行回顾性病历回顾。结果变量包括肺动脉高压危象、低心输出量综合征和早期死亡。结果:58例患者中,77.59%为心上连接部位,20.69%为心脏连接部位,1.72%为混合连接部位。86.21%的患者选择择期手术,13.79%的患者选择急诊手术。肺动脉高压危象的发生率为27.59%,低心输出量综合征的发生率为6.90%。体重低于6 kg、肺炎、心动过速、肝肿大、术前胸片肺充血、术前平均肺动脉压升高、术前肺静脉阻塞、急诊手术和主动脉交叉夹持时间延长是术后肺动脉高压危象的重要危险因素。术后低心输出量综合征的重要危险因素包括肺炎、术前机械通气时间延长和主动脉交叉夹持时间延长。结论:手术修复TAPVC的早期效果可接受,生存率为96.55%。目前的分析表明,对所有术前和手术特征进行全面评估是实现最佳医疗和手术结果的必要条件。
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引用次数: 2
Burden of Undiagnosed Hypertension among Adults in Urban Communities of Southwest Ethiopia. 埃塞俄比亚西南部城市社区成人未确诊高血压负担
IF 2.2 Q2 Medicine Pub Date : 2021-05-21 eCollection Date: 2021-01-01 DOI: 10.2147/IBPC.S293251
Solomon Berhanu Mogas, Temamen Tesfaye, Belay Zewde, Yonas Tesfaye, Ayantu Kebede, Mulualem Tadesse, Esayas Kebede Gudina, Dessalegn Tamiru, Lelisa Sena Dadi

Background: Hypertension (HTN) is the leading risk factor for mortality due to cardiovascular diseases, it accounts for 7% of global disability adjusted life years. In 2015, it was estimated that around 1.13 billion adults had HTN globally with a high prevalence in low and middle-income countries where the health system is weak to diagnose, treat, and control HTN. Most people with HTN are asymptomatic and go undiagnosed for years. Therefore, the aim of this study was to assess the burden of undiagnosed HTN among adults in urban communities of Southwest Ethiopia.

Methods: A community-based cross-sectional study involving 915 adults from June 17 to July 27, 2019 was performed. WHO STEPS questionnaire was used to collect data, and the collected data were entered using Epi Data version 3.1and analyzed using SPSS version 20, respectively. Binary logistic regression was used to check for a possible association between outcome and independent factors. P-value <0.05 and 95% CI were used on multivariable logistic regression analysis as threshold for significant statistical association.

Results: Undiagnosed HTN in the study area was 21.2% (194). Age (AOR=1.04, 95% CI=1.02-1.05), BMI with overweight (AOR=2.52, 95% CI=1.35-4.71), triglyceride (AOR=1.83, 95% CI=1.29-2.59), and waist to hip ratio (AOR=1.62, 95% CI=1.03-2.54) were factors significantly associated with HTN.

Conclusion: As compared to studies performed before, the risk of undiagnosed HTN in the current study was high. Age, BMI, triglyceride, and waist to hip ratios were found to be the significant factors for it. Preventing the risk factors and screening of HTN should be promoted for early detection, prevention, and treatment of the burden of the disease on the population.

背景:高血压(HTN)是导致心血管疾病死亡的主要危险因素,占全球残疾调整生命年的7%。2015年,估计全球约有11.3亿成年人患有HTN,在卫生系统诊断、治疗和控制HTN能力薄弱的低收入和中等收入国家发病率很高。大多数HTN患者无症状,多年未被确诊。因此,本研究的目的是评估埃塞俄比亚西南部城市社区成人未确诊HTN的负担。方法:2019年6月17日至7月27日,对915名成年人进行社区横断面研究。采用WHO STEPS问卷收集数据,收集数据采用Epi data 3.1版录入,采用SPSS 20版分析。使用二元逻辑回归来检验结果与独立因素之间可能存在的关联。p值结果:研究区未确诊的HTN占21.2%(194例)。年龄(AOR=1.04, 95% CI=1.02-1.05)、体重超重(AOR=2.52, 95% CI=1.35-4.71)、甘油三酯(AOR=1.83, 95% CI=1.29-2.59)、腰臀比(AOR=1.62, 95% CI=1.03-2.54)是HTN的显著相关因素。结论:与以往的研究相比,本研究中未确诊的HTN风险较高。年龄、身体质量指数、甘油三酯和腰臀比被发现是其重要因素。应促进预防危险因素和筛查HTN,以便及早发现、预防和治疗该疾病对人口造成的负担。
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引用次数: 11
The Role of Health Care Quality in Hypertension Self-Management: A Qualitative Study of the Experience of Patients in a Public Hospital, North-West Ethiopia. 卫生保健质量在高血压自我管理中的作用:对埃塞俄比亚西北部一家公立医院患者经验的定性研究
IF 2.2 Q2 Medicine Pub Date : 2021-04-27 eCollection Date: 2021-01-01 DOI: 10.2147/IBPC.S303100
Mohammed Hussien, Ahmed Muhye, Fantu Abebe, Fentie Ambaw

Purpose: Hypertension is becoming a global epidemic in all population groups. For its effective management and control, patients should have enhanced self-management skills and get adequate support from care providers. Although the quality of health care is critical in enhancing self-management behaviors of patients with hypertension, the issue has not been fully explored in the Ethiopian context. Therefore, the purpose of this study was to explore the experience of hypertensive patients on the quality of health care and the self-management practice in a public hospital in North-west Ethiopia.

Patients and methods: This qualitative study involves a phenomenological approach. Participants were hypertension patients who are on treatment follow-up. They were recruited purposively with maximum variation approach. Eleven in-depth interviews and two key informant interviews were undertaken using a semi-structured interview guide with hypertensive patients and nurses respectively. Interviews were audio recorded, transcribed verbatim, translated into English, and then analyzed thematically by the investigators.

Results: The analysis identified two main themes and seven sub-themes. The first theme "experience in self-management practice" describes medication adherence, lifestyle modification, and self-monitoring of blood pressure. The second theme "experience in the quality of health care" discusses access to health services, patient-centered care, behavior of health care providers, and time and patient flow management.

Conclusion: The self-management practice of hypertensive patients is sub-optimal. Although several individual patient issues were identified, facility-level problems are mainly responsible for poor self-management practice. The main facility-level barriers, as reported by participants, include shortage of medicines, high cost of medicines, busyness of doctors due to high patient load, lack of appropriate education and counseling services, poor patient-provider interaction, and long waiting times. Intervention areas should focus on providing appropriate training for health care providers to enhance the patient-provider relationship. Improving the supply of hypertensive medications is also paramount for better medication adherence.

目的:高血压正在成为所有人群中的全球性流行病。为使其得到有效的管理和控制,患者应提高自我管理技能,并得到护理人员的充分支持。虽然保健质量对加强高血压患者的自我管理行为至关重要,但在埃塞俄比亚的情况下,这一问题尚未得到充分探讨。因此,本研究旨在探讨埃塞俄比亚西北部某公立医院高血压患者对医疗保健质量和自我管理实践的体验。患者和方法:本定性研究采用现象学方法。参与者是接受治疗随访的高血压患者。他们是用最大变异法有目的地招募的。采用半结构化访谈指南对高血压患者和护士分别进行了11次深度访谈和2次关键信息提供者访谈。访谈录音,逐字抄录,翻译成英文,然后由调查人员按主题进行分析。结果:分析确定了两个主要主题和七个次要主题。第一个主题“自我管理实践的经验”描述了药物依从性、生活方式改变和自我监测血压。第二个主题“卫生保健质量的经验”讨论了获得卫生服务、以病人为中心的护理、卫生保健提供者的行为以及时间和病人流量管理。结论:高血压患者自我管理实践不理想。虽然确定了几个个别患者的问题,但设施层面的问题是导致自我管理不善的主要原因。与会者报告的主要设施层面障碍包括药品短缺、药品成本高、病人负荷大导致医生忙碌、缺乏适当的教育和咨询服务、患者与提供者互动不良以及等待时间长。干预领域应侧重于为卫生保健提供者提供适当的培训,以加强医患关系。改善高血压药物的供应对于提高服药依从性也至关重要。
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引用次数: 3
Prevalence of Hypertension and Its Associated Factors Among Adults in Areka Town, Wolaita Zone, Southern Ethiopia. 埃塞俄比亚南部Wolaita地区Areka镇成人高血压患病率及其相关因素
IF 2.2 Q2 Medicine Pub Date : 2021-03-16 eCollection Date: 2021-01-01 DOI: 10.2147/IBPC.S295574
Ufaysa Anjulo, Dereje Haile, Anbessaw Wolde

Background: Hypertension is an emerging public health problem in many low- and middle-income countries including Ethiopia. However, there are limited studies and data are scarce in these countries, particularly in Ethiopia. Thus, the aim of this study was to assess the prevalence of hypertension and its associated factors in this study area.

Methods: A community-based cross-sectional study was conducted in Areka town. Multi-stage sampling technique was used to select 581 adults. Information on socio-demographic data, behavioral and dietary habits, and family history of hypertension were collected using face-to-face interview. Measurements of weight, height, and blood pressure were taken using digital weighing scale, Stadio-meter, and digital sphygmomanometer respectively. Data were entered and cleaned in Epi-Data version 3.1, and exported to SPSS version 20 for analysis. Binary logistic regressions were done and odds ratios with 95% confidence intervals were calculated to identify associated factors.

Results: The overall prevalence of hypertension among the study participants was 19.1% (95% CI: 15.9-22.4). Out of these, more than half (57.3%) of the cases were newly screened for hypertension. In a multivariate logistic regression analysis; history of perceived childhood obesity (AOR:2.8 (95% CI:1.6,5.1)), age 55 years and above (AOR=8.90, 95% CI: 3.77-21.02), family history of hypertension (AOR= 2.57, 95% CI: 1.17-5.64), fatty meat intake (AOR=1.96, 95% CI: 1.05-3.65), eating vegetables less than two days per week (AOR=2.81, 95% CI: 1.24-6.37) and being obese (AOR=11.59, 95% CI: 4.7-27.62) were associated factors of developing hypertension.

Conclusion: The study revealed that the prevalence was found to be high among adults indicating the hidden burden of the problem in the area. Therefore, the health systems need to develop strategies for community-based screening, strategies that focus on life cycle-based approach because childhood and adolescence are crucial times for the prevention of NCDs including hypertension. Health education on eating behavior and life style modifications to maintain normal body weight are recommended.

背景:高血压在包括埃塞俄比亚在内的许多低收入和中等收入国家是一个新出现的公共卫生问题。然而,在这些国家,特别是在埃塞俄比亚,研究有限,数据匮乏。因此,本研究的目的是评估该研究地区的高血压患病率及其相关因素。方法:在Areka镇进行以社区为基础的横断面研究。采用多阶段抽样法,抽取成人581人。采用面对面访谈法收集高血压患者的社会人口统计资料、行为和饮食习惯、家族史等信息。分别用数字称、体重计和数字血压计测量体重、身高和血压。在Epi-Data 3.1版本中输入和清理数据,导出到SPSS 20版本进行分析。进行二元logistic回归,并计算95%置信区间的比值比以确定相关因素。结果:研究参与者中高血压的总体患病率为19.1% (95% CI: 15.9-22.4)。其中,超过一半(57.3%)的病例是新近接受高血压筛查的。在多元逻辑回归分析中;儿童期肥胖史(AOR:2.8 (95% CI:1.6,5.1))、55岁及以上(AOR=8.90, 95% CI: 3.77-21.02)、高血压家族史(AOR= 2.57, 95% CI: 1.17-5.64)、肥肉摄入(AOR=1.96, 95% CI: 1.05-3.65)、每周吃蔬菜少于2天(AOR=2.81, 95% CI: 1.24-6.37)和肥胖(AOR=11.59, 95% CI: 4.7-27.62)是发生高血压的相关因素。结论:调查结果显示,该地区成人的患病率较高,存在隐性负担。因此,卫生系统需要制定以社区为基础的筛查战略,这些战略侧重于基于生命周期的方法,因为儿童和青少年是预防包括高血压在内的非传染性疾病的关键时期。建议对饮食行为和生活方式进行健康教育,以保持正常体重。
{"title":"Prevalence of Hypertension and Its Associated Factors Among Adults in Areka Town, Wolaita Zone, Southern Ethiopia.","authors":"Ufaysa Anjulo,&nbsp;Dereje Haile,&nbsp;Anbessaw Wolde","doi":"10.2147/IBPC.S295574","DOIUrl":"https://doi.org/10.2147/IBPC.S295574","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is an emerging public health problem in many low- and middle-income countries including Ethiopia. However, there are limited studies and data are scarce in these countries, particularly in Ethiopia. Thus, the aim of this study was to assess the prevalence of hypertension and its associated factors in this study area.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted in Areka town. Multi-stage sampling technique was used to select 581 adults. Information on socio-demographic data, behavioral and dietary habits, and family history of hypertension were collected using face-to-face interview. Measurements of weight, height, and blood pressure were taken using digital weighing scale, Stadio-meter, and digital sphygmomanometer respectively. Data were entered and cleaned in Epi-Data version 3.1, and exported to SPSS version 20 for analysis. Binary logistic regressions were done and odds ratios with 95% confidence intervals were calculated to identify associated factors.</p><p><strong>Results: </strong>The overall prevalence of hypertension among the study participants was 19.1% (95% CI: 15.9-22.4). Out of these, more than half (57.3%) of the cases were newly screened for hypertension. In a multivariate logistic regression analysis; history of perceived childhood obesity (AOR:2.8 (95% CI:1.6,5.1)), age 55 years and above (AOR=8.90, 95% CI: 3.77-21.02), family history of hypertension (AOR= 2.57, 95% CI: 1.17-5.64), fatty meat intake (AOR=1.96, 95% CI: 1.05-3.65), eating vegetables less than two days per week (AOR=2.81, 95% CI: 1.24-6.37) and being obese (AOR=11.59, 95% CI: 4.7-27.62) were associated factors of developing hypertension.</p><p><strong>Conclusion: </strong>The study revealed that the prevalence was found to be high among adults indicating the hidden burden of the problem in the area. Therefore, the health systems need to develop strategies for community-based screening, strategies that focus on life cycle-based approach because childhood and adolescence are crucial times for the prevention of NCDs including hypertension. Health education on eating behavior and life style modifications to maintain normal body weight are recommended.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2021-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/13/82/ibpc-14-43.PMC7981153.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25511907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Risk Factors and Comorbidities in Young Indian Patients with Hypertension: REAL YOUNG (Hypertension) Study. 印度年轻高血压患者的危险因素和合并症:REAL Young(高血压)研究
IF 2.2 Q2 Medicine Pub Date : 2021-02-26 eCollection Date: 2021-01-01 DOI: 10.2147/IBPC.S272548
Nagaraj Desai, Govindan Unni, Rajeev Agarwala, Santosh Salagre, Sanjay Godbole, Ashish Dengra, Mahesh V Abhyankar, Santosh Revankar

Purpose: To analyze the risk factors and comorbidities among the young Indian adults with hypertension.

Patients and methods: This was a retrospective, multicentric real-world study which included patients diagnosed with and receiving treatment for hypertension. Data were collected from the medical records of clinics/hospitals across 623 study sites in India. Patients of either sex and aged 18-45 years were included. Demographic details (age, sex, anthropometric measurement), medical and family history, sedentary lifestyle, smoking status and alcohol consumption data were extracted. Descriptive and comparative analysis (Mann-Whitney U and chi-squared test) was done.

Results: Out of 15,006 young patients diagnosed with hypertension (men=63.6%), 65.7% belonged to the age group of >35-45 years. The median body mass index was 27.0 kg/m2. Patients diagnosed with only hypertension were 29.1% while other predominant comorbidities with hypertension were diabetes mellitus (42.4%) and dyslipidemia (7.8%). Hypertension with diabetes mellitus were prevalent in the age group of >35-45 years (43.8%). More than half of the patients with hypertension (n=7656) had a sedentary lifestyle. Overall, 35.6%, 47.3%, and 56.7% of the patients were alcoholic, smokers (present and former), and had a family history of hypertension, respectively.

Conclusion: The results showed that among the young population, hypertension was common in the age group of >35-45 years and diabetes mellitus and dyslipidemia were common comorbidities. Family history, sedentary lifestyle, smoking, alcohol consumption, and body mass index may also contribute to hypertension.

目的:分析印度青年高血压患者的危险因素及合并症。患者和方法:这是一项回顾性的、多中心的现实世界研究,包括诊断为高血压并接受治疗的患者。数据是从印度623个研究地点的诊所/医院的医疗记录中收集的。患者不分性别,年龄在18-45岁之间。提取了人口统计细节(年龄、性别、人体测量值)、病史和家族史、久坐生活方式、吸烟状况和饮酒数据。进行了描述性和比较分析(Mann-Whitney U和卡方检验)。结果:15,006例年轻高血压患者(男性占63.6%)中,65.7%的患者年龄>35-45岁。中位体重指数为27.0 kg/m2。仅诊断为高血压的患者占29.1%,而高血压的其他主要合并症是糖尿病(42.4%)和血脂异常(7.8%)。高血压合并糖尿病多见于>35 ~ 45岁年龄组(43.8%)。超过一半的高血压患者(n=7656)有久坐的生活方式。总体而言,35.6%、47.3%和56.7%的患者分别为酗酒者、吸烟者(现在和以前)和有高血压家族史。结论:青壮年人群中高血压多见于>35 ~ 45岁年龄组,糖尿病和血脂异常是常见的合并症。家族史、久坐不动的生活方式、吸烟、饮酒和体重指数也可能导致高血压。
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引用次数: 2
Are Community Health Center Patients Interested in Self-Measured Blood Pressure Monitoring (SMBP) - And Can They Do It? 社区卫生中心的病人对自我测量血压监测(SMBP)感兴趣吗?他们能做到吗?
IF 2.2 Q2 Medicine Pub Date : 2021-02-12 eCollection Date: 2021-01-01 DOI: 10.2147/IBPC.S285007
Debosree Roy, Margaret Meador, Nana Sasu, Kate Whelihan, Joy H Lewis

Introduction: Self-measured blood pressure monitoring (SMBP) helps diagnose and manage hypertension from outside the clinic, which has implications for patient empowerment and outcomes, continuity of care, and resilience in care communities catering to vulnerable populations.

Methods: We instituted a protocol for SMBP among hypertensive patients at 9 community health centers in 3 states and administered questionnaires to patients before and after the protocol was instituted to assess knowledge and engagement with disease management, beliefs and attitudes towards, and experience doing SMBP. Questionnaires included 16 items designed to evaluate patient perceptions and beliefs about SMBP. These included a series of questions using a 5-point Likert scale, binary questions related to their perceived ability to comply with specific SMBP guidelines and open-ended questions to obtain descriptions of experiences with SMBP.

Results: The pre-questionnaire was completed by 478 patients and the post-questionnaire was completed by 372. Seventy-seven percent of respondents knew their ideal blood pressure and their engagement with blood pressure management increased significantly (p=0.0024) after completing the protocol. Additionally, 85% of respondents said that they had a positive experience doing SMBP. Open-ended responses revealed insight regarding why patients chose to do SMBP and factors patients appreciated about SMBP.

Discussion: When trained properly and supported, community health center patients are capable of and motivated to perform accurate SMBP. Our study provides evidence that health center patients can follow detailed SMBP protocols and monitor their own blood pressure from the safety of their homes, which is critical to their care continuum, particularly in days of a pandemic.

自我测量血压监测(SMBP)有助于在诊所外诊断和管理高血压,这对患者赋权和结果、护理的连续性以及面向弱势群体的护理社区的恢复力具有重要意义。方法:我们在3个州的9个社区卫生中心对高血压患者制定了SMBP方案,并在方案制定前后对患者进行问卷调查,以评估患者对疾病管理的知识和参与程度、对SMBP的信念和态度以及实施SMBP的经验。问卷包括16个项目,旨在评估患者对SMBP的看法和信念。这些问题包括一系列使用5点李克特量表的问题,与他们遵守特定SMBP指南的感知能力相关的二元问题,以及获得SMBP经验描述的开放式问题。结果:完成问卷前调查478例,完成问卷后调查372例。77%的受访者知道自己的理想血压,完成方案后,他们对血压管理的参与度显著增加(p=0.0024)。此外,85%的受访者表示他们在SMBP中获得了积极的体验。开放式回答揭示了患者选择SMBP的原因以及患者对SMBP的欣赏因素。讨论:在适当的培训和支持下,社区卫生中心的患者有能力和动力执行准确的SMBP。我们的研究提供了证据,表明卫生中心的患者可以遵循详细的SMBP协议,并在家中安全监测自己的血压,这对他们的护理连续性至关重要,特别是在大流行的日子里。
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引用次数: 4
Evidence of Nonadherence in Cases of Pseudoresistant Hypertension. 假性顽固性高血压病例的不依从证据。
IF 2.2 Q2 Medicine Pub Date : 2021-02-11 eCollection Date: 2021-01-01 DOI: 10.2147/IBPC.S264057
João Marcos de Menezes Zanatta, Luciana Neves Cosenso-Martin, Valquíria da Silva Lopes, Jéssica Rodrigues Roma Uyemura, Aleandra Marton Polegati Santos, Manoel Ildefonso Paz Landim, Juan Carlos Yugar-Toledo, José Fernando Vilela-Martin

Resistant hypertension (RH) is characterized by the use of three or more antihypertensive drugs without reaching the goal of controlling blood pressure (BP). For a definitive diagnosis of RH, it is necessary to exclude causes of pseudoresistance, including the white-coat effect, errors in BP measurement, secondary hypertension, therapeutic inertia, and poor adherence to lifestyle changes and pharmacological treatment. Herein, we report the history of a patient with long-standing uncontrolled BP, even when using seven antihypertensive drugs. Causes of secondary hypertension that justified the high BP levels were investigated, in addition to the other causes of pseudo-RH. In view of the difficult-to-control BP situation, it was decided to hospitalize the patient for better investigation. After 5 days, he had BP control with practically the same medications previously used. Finally, all factors related to the presence of pseudo-RH are discussed, especially poor adherence to treatment. Poor adherence to antihypertensive treatment is common in daily medical practice, and its investigation is of fundamental importance for better management of BP.

顽固性高血压(RH)的特点是使用三种或三种以上的降压药,但没有达到控制血压的目标。对于RH的明确诊断,有必要排除假耐药的原因,包括白大褂效应、血压测量误差、继发性高血压、治疗惰性、生活方式改变和药物治疗依从性差。在此,我们报告了一个长期不受控制的血压患者的病史,即使使用了七种抗高血压药物。除了假性rh的其他原因外,还调查了继发性高血压的原因,证明了高血压水平的合理性。鉴于血压难以控制的情况,决定住院治疗,以便更好地进行调查。5天后,他的血压得到了控制,使用的药物几乎与之前使用的相同。最后,讨论了与假性rh存在相关的所有因素,特别是治疗依从性差。降压治疗依从性差是日常医疗实践中常见的问题,其调查对更好地管理BP具有重要意义。
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引用次数: 1
Blood Pressure Control with Reference to Intensive Blood Pressure Targets Among Hypertension Patients on Chronic Follow-Up at Dessie Referral Hospital, Northeast Ethiopia. 埃塞俄比亚东北部Dessie转诊医院高血压患者慢性随访中强化血压指标的血压控制
IF 2.2 Q2 Medicine Pub Date : 2021-01-22 eCollection Date: 2021-01-01 DOI: 10.2147/IBPC.S268186
Kassahun Bogale, Assasu Aderaw

Background: Hypertension is a risk factor for heart, brain, kidney, and other diseases. It is also the major cause of premature death. Thus, it is important to prevent, treat, and control hypertension and to reduce the risk of cardiovascular disease.

Objective: To determine the level of blood pressure control and associated factors based on the new intensive blood pressure goals (<130/80 mmHg).

Methods: A cross-sectional study design was used to assess the level of blood pressure control and associated factors from February 15 to April 15, 2019. Two hundred and sixteen patients were selected through a systematic sampling technique.

Results: From 203 hypertension patients incorporated in the study, 102 (50.2%) were females. The mean age of patients documented during the last date of follow-up was 55.2 (SD=±14.47). About 51.2% of patients were less than 5 years from the day of diagnosis of hypertension. The majority of the study participants (111, 54.7%) were using two antihypertensives. The most common anti-hypertensive medication was hydrochlorothiazide (HCT), at 25 (12.3%). The most common combination drug therapy used was the combination of HCT and calcium channel blockers, at 62 (30.5%). Heart failure (22, 20.8%), stroke (18, 16.98%), and dyslipidemia (17, 16.04%) were the top three comorbidities. Based on the new intensive targets of blood pressure control (<130/80 mmHg), the blood pressure was controlled for only 25 (12%) patients.

Conclusion: The level of blood pressure control for hypertensive patients on chronic follow-up at Dessie Referral Hospital was very poor.

背景:高血压是心、脑、肾和其他疾病的危险因素。它也是过早死亡的主要原因。因此,预防、治疗和控制高血压以及降低心血管疾病的风险是非常重要的。目的:根据新的强化血压目标确定患者的血压控制水平及相关因素(方法:采用横断面研究设计,评估2019年2月15日至4月15日患者的血压控制水平及相关因素。通过系统抽样技术选取216例患者。结果:203例高血压患者中,女性102例(50.2%)。最后一次随访时记录的患者平均年龄为55.2岁(SD=±14.47)。约51.2%的患者自诊断为高血压之日起不到5年。大多数研究参与者(111人,54.7%)同时使用两种抗高血压药物。最常见的降压药物是氢氯噻嗪(HCT),占25%(12.3%)。最常见的联合药物治疗是HCT和钙通道阻滞剂的联合治疗,占62%(30.5%)。心衰(22,20.8%)、中风(18,16.98%)和血脂异常(17,16.04%)是前三大合并症。结论:德西转诊医院慢性随访高血压患者血压控制水平较差。
{"title":"Blood Pressure Control with Reference to Intensive Blood Pressure Targets Among Hypertension Patients on Chronic Follow-Up at Dessie Referral Hospital, Northeast Ethiopia.","authors":"Kassahun Bogale,&nbsp;Assasu Aderaw","doi":"10.2147/IBPC.S268186","DOIUrl":"https://doi.org/10.2147/IBPC.S268186","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a risk factor for heart, brain, kidney, and other diseases. It is also the major cause of premature death. Thus, it is important to prevent, treat, and control hypertension and to reduce the risk of cardiovascular disease.</p><p><strong>Objective: </strong>To determine the level of blood pressure control and associated factors based on the new intensive blood pressure goals (<130/80 mmHg).</p><p><strong>Methods: </strong>A cross-sectional study design was used to assess the level of blood pressure control and associated factors from February 15 to April 15, 2019. Two hundred and sixteen patients were selected through a systematic sampling technique.</p><p><strong>Results: </strong>From 203 hypertension patients incorporated in the study, 102 (50.2%) were females. The mean age of patients documented during the last date of follow-up was 55.2 (SD=±14.47). About 51.2% of patients were less than 5 years from the day of diagnosis of hypertension. The majority of the study participants (111, 54.7%) were using two antihypertensives. The most common anti-hypertensive medication was hydrochlorothiazide (HCT), at 25 (12.3%). The most common combination drug therapy used was the combination of HCT and calcium channel blockers, at 62 (30.5%). Heart failure (22, 20.8%), stroke (18, 16.98%), and dyslipidemia (17, 16.04%) were the top three comorbidities. Based on the new intensive targets of blood pressure control (<130/80 mmHg), the blood pressure was controlled for only 25 (12%) patients.</p><p><strong>Conclusion: </strong>The level of blood pressure control for hypertensive patients on chronic follow-up at Dessie Referral Hospital was very poor.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2021-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/7c/ibpc-14-1.PMC7837537.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25314492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ambulatory Blood Pressure Profiles and Correlation with Cardiovascular Risk Factors in a Sample of 390 University Employees in Tanzania. 坦桑尼亚390名大学员工动态血压特征及其与心血管危险因素的相关性
IF 2.2 Q2 Medicine Pub Date : 2020-12-23 eCollection Date: 2020-01-01 DOI: 10.2147/IBPC.S280763
Godfrey Chuwa, Pilly Chillo

Background: Hypertension is a major risk factor for cardiovascular morbidity and mortality. Increasingly, evidence suggests that 24-hour ambulatory blood pressure (BP) monitoring (ABPM) is more accurate than clinic BP in predicting cardiovascular risk. However, this association has not been widely studied in subSaharan Africa, especially in Tanzania.

Aim: To explore the relationship between 24-hour ABPM profiles and cardiovascular risk factors in comparison with clinic BP among Muhimbili University of Health and Allied Sciences (MUHAS) employees.

Methods: A descriptive cross-sectional study was conducted from October 2018 to February 2019. Socio-demographic and cardiovascular risk information was gathered. We used an automated ABPM device to record 24-hour ambulatory BP. Correlation between BP profiles and cardiovascular risk factors was done using Pearson's correlation coefficient, and independent factors for hypertension were determined using logistic regression analysis. P-value of <0.05 was considered statistically significant.

Results: In total, 390 employees participated. Their mean age was 40.5 ± 8.9 years, and 53.6% were men. The mean office systolic and diastolic BP were 126±12 mmHg and 78±13 mmHg, respectively, while the corresponding values for mean 24-hour ABPM were 122±14 and 75±10 mmHg. The prevalence of hypertension was 23.1%. The prevalence of white coat hypertension was 16.2%, while masked hypertension and nocturnal non-dipping were present in 11.5 and 66.7%, respectively. Overall, the mean 24-hour systolic BP showed the strongest correlations with cardiovascular risk factors while mean office systolic BP showed least. Independent associated factors of hypertension were male gender, age ≥40 years, family history of hypertension, central obesity, raised cholesterol and uric acid levels, all p<0.01.

Conclusion: Compared to office BP, ABPM measurements had stronger correlations with cardiovascular risk factors in this population, and therefore likely to reflect true BP. ABPM has revealed high proportion of masked, white coat and nocturnal non-dipping, supporting use of ABPM to detect these clinically important BP profiles.

背景:高血压是心血管疾病发病和死亡的主要危险因素。越来越多的证据表明,24小时动态血压监测(ABPM)在预测心血管风险方面比临床血压更准确。然而,在撒哈拉以南非洲,特别是坦桑尼亚,这种联系尚未得到广泛研究。目的:探讨Muhimbili卫生与联合科学大学(MUHAS)员工24小时血压与心血管危险因素的关系。方法:于2018年10月至2019年2月进行描述性横断面研究。收集社会人口统计学和心血管风险信息。我们使用自动ABPM设备记录24小时动态血压。采用Pearson相关系数分析血压与心血管危险因素的相关性,采用logistic回归分析确定高血压的独立因素。结果的p值:共有390名员工参与。平均年龄40.5±8.9岁,男性53.6%。平均收缩压和舒张压分别为126±12 mmHg和78±13 mmHg,平均24小时ABPM分别为122±14和75±10 mmHg。高血压患病率为23.1%。白大褂高血压患病率为16.2%,隐匿性高血压和夜间不沾高血压患病率分别为11.5%和66.7%。总体而言,平均24小时收缩压与心血管危险因素的相关性最强,而平均办公室收缩压与心血管危险因素的相关性最小。高血压的独立相关因素有男性、年龄≥40岁、高血压家族史、中心性肥胖、胆固醇和尿酸水平升高等。结论:与办公室血压相比,ABPM测量与该人群心血管危险因素的相关性更强,因此可能反映真实的血压。ABPM显示了高比例的蒙面、白大褂和夜间不浸入,支持使用ABPM检测这些临床重要的血压特征。
{"title":"Ambulatory Blood Pressure Profiles and Correlation with Cardiovascular Risk Factors in a Sample of 390 University Employees in Tanzania.","authors":"Godfrey Chuwa,&nbsp;Pilly Chillo","doi":"10.2147/IBPC.S280763","DOIUrl":"https://doi.org/10.2147/IBPC.S280763","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a major risk factor for cardiovascular morbidity and mortality. Increasingly, evidence suggests that 24-hour ambulatory blood pressure (BP) monitoring (ABPM) is more accurate than clinic BP in predicting cardiovascular risk. However, this association has not been widely studied in subSaharan Africa, especially in Tanzania.</p><p><strong>Aim: </strong>To explore the relationship between 24-hour ABPM profiles and cardiovascular risk factors in comparison with clinic BP among Muhimbili University of Health and Allied Sciences (MUHAS) employees.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted from October 2018 to February 2019. Socio-demographic and cardiovascular risk information was gathered. We used an automated ABPM device to record 24-hour ambulatory BP. Correlation between BP profiles and cardiovascular risk factors was done using Pearson's correlation coefficient, and independent factors for hypertension were determined using logistic regression analysis. <i>P</i>-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>In total, 390 employees participated. Their mean age was 40.5 ± 8.9 years, and 53.6% were men. The mean office systolic and diastolic BP were 126±12 mmHg and 78±13 mmHg, respectively, while the corresponding values for mean 24-hour ABPM were 122±14 and 75±10 mmHg. The prevalence of hypertension was 23.1%. The prevalence of white coat hypertension was 16.2%, while masked hypertension and nocturnal non-dipping were present in 11.5 and 66.7%, respectively. Overall, the mean 24-hour systolic BP showed the strongest correlations with cardiovascular risk factors while mean office systolic BP showed least. Independent associated factors of hypertension were male gender, age ≥40 years, family history of hypertension, central obesity, raised cholesterol and uric acid levels, all p<0.01.</p><p><strong>Conclusion: </strong>Compared to office BP, ABPM measurements had stronger correlations with cardiovascular risk factors in this population, and therefore likely to reflect true BP. ABPM has revealed high proportion of masked, white coat and nocturnal non-dipping, supporting use of ABPM to detect these clinically important BP profiles.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/d3/ibpc-13-197.PMC7767712.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38766337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Peri-Procedural Blood Pressure Changes and Their Relationship with MACE in Patients Undergoing Percutaneous Coronary Intervention: A Cross-Sectional Study. 经皮冠状动脉介入治疗患者术中血压变化及其与MACE的关系:一项横断面研究。
IF 2.2 Q2 Medicine Pub Date : 2020-12-10 eCollection Date: 2020-01-01 DOI: 10.2147/IBPC.S268848
Susan Labib, Hussein Heshmat Kassem, Hossam Kandil

Background: Peri-procedural blood-pressure (BP) changes were investigated and correlated to Major adverse cardiovascular events (MACE) as predictor of outcome for patients undergoing percutaneous coronary intervention (PCI); whether acute coronary syndrome (Unstable angina, or MI; STEMI or NSTEMI) or scheduled for elective PCI.

Methods: Resting BP in the 204 recruited patients undergoing PCI throughout 2018 was measured thrice - in the ward before transferring to the cardiac catheterization lab (cath lab), in the cath lab, and after transfer to the recovery room. Patients were categorized based on their systolic and diastolic BP peri-procedural difference as systolic (SBP): with a large difference (>20 mmHg, n=47), with a small difference (≤20 mmHg, n=157) (shock patients excluded); diastolic (DBP): with a large difference (>10 mmHg, n=65), and with a small difference (≤10 mmHg, n=139). The primary end-points were MACE including all-cause mortality, non-fatal myocardial infarction, and stroke during the hospital stay. The Mann-Whitney U and Chi-square tests were used to analyze the data accordingly (p<0.005).

Results: Within the category of MACE, cardiac mortality was the only adverse cardiac event encountered in the study sample. Cardiac mortality was significantly higher in both the large SBP-difference group versus the other group (10.6% vs 0.6%, p=0.003) and the large DBP-difference group versus the small-difference group (7.7% vs 0.7%, p=0.013).

Conclusion: Peri-procedural systolic and diastolic BP differences, greater than 20 mmHg and 10 mmHg, respectively, correlated with MACE in all patients undergoing PCI.

背景:研究了术中血压(BP)变化与主要不良心血管事件(MACE)的相关性,并将其作为经皮冠状动脉介入治疗(PCI)患者预后的预测因子;是否急性冠状动脉综合征(不稳定型心绞痛,或心肌梗死);STEMI或NSTEMI)或计划进行选择性PCI。方法:对2018年全年接受PCI治疗的204例患者的静息血压进行了三次测量,分别是在转入心导管实验室(cath lab)前、在cath实验室和转入康复室后。根据患者的收缩压和舒张压围手术期差异将患者分为收缩压(SBP):差异大(>20 mmHg, n=47),差异小(≤20 mmHg, n=157)(排除休克患者);舒张压(DBP):差异较大(> 10mmhg, n=65),差异较小(≤10mmhg, n=139)。主要终点为MACE,包括住院期间的全因死亡率、非致死性心肌梗死和卒中。使用Mann-Whitney U检验和卡方检验对数据进行相应的分析(结果:在MACE类别中,心脏死亡是研究样本中遇到的唯一不良心脏事件。舒张压差异大组的心脏死亡率显著高于其他组(10.6% vs 0.6%, p=0.003),舒张压差异大组的心脏死亡率显著高于舒张压差异小组(7.7% vs 0.7%, p=0.013)。结论:所有PCI患者术中收缩压和舒张压差异分别大于20mmhg和10mmhg与MACE相关。
{"title":"Peri-Procedural Blood Pressure Changes and Their Relationship with MACE in Patients Undergoing Percutaneous Coronary Intervention: A Cross-Sectional Study.","authors":"Susan Labib,&nbsp;Hussein Heshmat Kassem,&nbsp;Hossam Kandil","doi":"10.2147/IBPC.S268848","DOIUrl":"https://doi.org/10.2147/IBPC.S268848","url":null,"abstract":"<p><strong>Background: </strong>Peri-procedural blood-pressure (BP) changes were investigated and correlated to Major adverse cardiovascular events (MACE) as predictor of outcome for patients undergoing percutaneous coronary intervention (PCI); whether acute coronary syndrome (Unstable angina, or MI; STEMI or NSTEMI) or scheduled for elective PCI.</p><p><strong>Methods: </strong>Resting BP in the 204 recruited patients undergoing PCI throughout 2018 was measured thrice - in the ward before transferring to the cardiac catheterization lab (cath lab), in the cath lab, and after transfer to the recovery room. Patients were categorized based on their systolic and diastolic BP peri-procedural difference as systolic (SBP): with a large difference (>20 mmHg, n=47), with a small difference (≤20 mmHg, n=157) (shock patients excluded); diastolic (DBP): with a large difference (>10 mmHg, n=65), and with a small difference (≤10 mmHg, n=139). The primary end-points were MACE including all-cause mortality, non-fatal myocardial infarction, and stroke during the hospital stay. The Mann-Whitney U and Chi-square tests were used to analyze the data accordingly (p<0.005).</p><p><strong>Results: </strong>Within the category of MACE, cardiac mortality was the only adverse cardiac event encountered in the study sample. Cardiac mortality was significantly higher in both the large SBP-difference group versus the other group (10.6% vs 0.6%, p=0.003) and the large DBP-difference group versus the small-difference group (7.7% vs 0.7%, p=0.013).</p><p><strong>Conclusion: </strong>Peri-procedural systolic and diastolic BP differences, greater than 20 mmHg and 10 mmHg, respectively, correlated with MACE in all patients undergoing PCI.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2020-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S268848","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38736215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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Integrated Blood Pressure Control
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