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Hypertension Control (hypertension + control)
Selected AbstractsBarriers to Optimal Hypertension ControlJOURNAL OF CLINICAL HYPERTENSION, Issue 8 2008Gbenga Ogedegbe MD There is an obvious gap in the translation of clinical trial evidence into practice with regards to optimal hypertension control. The three major categories of barriers to BP control are patient-related, physician-related, and medical environment/health care system factors. Patient-related barriers include poor medication adherence, beliefs about hypertension and its treatment, depression, health literacy, comorbidity, and patient motivation. The most pertinent is medication adherence, given its centrality to the other factors. The most salient physician-related barrier is clinical inertia,defined, as the failure of health care providers to initiate or intensify drug therapy in a patient with uncontrolled BP. The major reasons for clinical inertia are: 1) overestimation of the amount of care that physicians provide; 2) lack of training on how to attain target BP levels; and 3) clinicians' use of soft reasons to avoid treatment intensification by adopting a "wait until next visit" approach in response to patients' excuses. [source] Optimizing Hypertension Control in Patients With Multiple Cardiovascular Risk FactorsJOURNAL OF CLINICAL HYPERTENSION, Issue 2006John Brian Copley MD No abstract is available for this article. [source] Optimal treatment of hypertension in the elderly: A Korean perspectiveGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2008Kwang-Il Kim With the progression of the aging population, common diseases of the elderly have become the center of attention in most developed countries. Hypertension is one of the most common morbid conditions in the elderly and has a great impact on their health status because it is the main risk factor of cardiovascular and cerebrovascular diseases. However, a considerable amount of uncertainty remains regarding hypertension in the elderly, such as the benefits of hypertension control in oldest-old populations, the optimal level of blood pressure control, and the efficacy of antihypertensive drugs for the prevention of cognitive dysfunction. While there are many controversial issues concerning the optimal management of hypertension in the elderly, the number of elderly hypertensive patients that require treatment is expected to increase due to the aging population. As a result, knowledge regarding the mechanisms of hypertension in the elderly and specific consideration in managing hypertensive elderly patients are needed to improve the clinical outcome. Furthermore, new therapeutic interventions that are aimed at attenuating age-related vascular changes should be investigated, because hypertension in the elderly, especially isolated systolic hypertension has specific characteristics of increased arterial stiffness in most cases. [source] Obesity,hypertension: an ongoing pandemicINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2007E. A. Francischetti Summary Considerable evidence has suggested that excessive weight gain is the most common cause of arterial hypertension. This association has been observed in several populations, in different regions of the world. Obesity,hypertension, a term that underscores the link between these two deleterious conditions, is an important public health challenge, because of its high frequency and concomitant risk of cardiovascular and kidney diseases. The obesity,hypertension pandemic imposes a considerable economic burden on societies, directly reflecting on healthcare system costs. Increased renal sodium reabsorption and blood volume expansion are central features in the development of obesity,hypertension. Overweight is also associated with increased sympathetic activity. Leptin, a protein expressed in and secreted by adipocytes, is the main factor linking obesity, increased sympathetic nervous system activity and hypertension. The renin,angiotensin,aldosterone system has also been causally implicated in obesity,hypertension, because angiotensinogen is expressed in and secreted by adipose tissue. Hypoadiponectinemia, high circulating levels of free fatty acids and increased vascular production of endothelin-1 (ET-1) have been reported as potential mechanisms for obesity,hypertension. Lifestyle changes are effective in obesity,hypertension control, though pharmacological treatment is frequently necessary. Despite the consistency of the mechanistic approach in explaining the causal relation between hypertension and obesity, there is yet no evidence that one class of drug is superior to the others in controlling obesity,hypertension. In this review, we present the current knowledge and research in obesity,hypertension, exploring the epidemiologic evidence of the association, its probable pathophysiological mechanisms and treatment issues. [source] Barriers to Optimal Hypertension ControlJOURNAL OF CLINICAL HYPERTENSION, Issue 8 2008Gbenga Ogedegbe MD There is an obvious gap in the translation of clinical trial evidence into practice with regards to optimal hypertension control. The three major categories of barriers to BP control are patient-related, physician-related, and medical environment/health care system factors. Patient-related barriers include poor medication adherence, beliefs about hypertension and its treatment, depression, health literacy, comorbidity, and patient motivation. The most pertinent is medication adherence, given its centrality to the other factors. The most salient physician-related barrier is clinical inertia,defined, as the failure of health care providers to initiate or intensify drug therapy in a patient with uncontrolled BP. The major reasons for clinical inertia are: 1) overestimation of the amount of care that physicians provide; 2) lack of training on how to attain target BP levels; and 3) clinicians' use of soft reasons to avoid treatment intensification by adopting a "wait until next visit" approach in response to patients' excuses. [source] The effect of Chinese food therapy on community dwelling Chinese hypertensive patients with Yin-deficiencyJOURNAL OF CLINICAL NURSING, Issue 7-8 2010CuiZhen Shen Objectives., The objectives of this study are to evaluate the effectiveness of Chinese food therapy in correcting the Yin-deficiency and to examine its impact on the patients' quality of life and hypertension control. Background., Epidemiological studies have shown 14,50% of people with hypertension have Yin-deficiency. Whether restoring the Yin,Yang balance by means of Chinese food therapy can help to better manage patients with hypertension has yet to be examined. Design., Two groups randomised controlled trial. Methods., Eighty-five hypertensive patients recruited from two community health service centre were divided into two groups. The intervention group (n = 48) received specific dietary instructions and corresponding management of their antihypertensive medication if indicated and brief health education, whilst the control group (n = 37) received routine support involving only brief health education. Data were collected at baseline, after intervention at four, eight, 12 and 16 weeks follow-up. Comparisons were made to examine the effects of Chinese food therapy on Yin-deficiency symptoms, blood pressure and quality of life of hypertensive patients. Results., The intervention group had reduction in the numbers of antihypertensive medication taken as well as improvement in most of the Yin-deficiency symptoms after 12 weeks of Chinese food therapy and mean scores of several SF-36 dimensions were higher than that of in the control group after 12 and 16 weeks follow-up. Significant difference was found in systolic blood pressure in the intervention group when it was compared from baseline to after four and eight weeks respectively. Conclusion., Chinese Food Therapy can restore body constitution with Yin,Yang imbalance and may potentially improve hypertensive patients' quality of life. It is also beneficial in controlling blood pressure in hypertensive patients. Relevance to clinical practice., Chinese food therapy may become a complementary therapy in health care and it should be a component of nursing education and health education. [source] SELECTION OF PATIENTS FOR SURGERY FOR PRIMARY ALDOSTERONISMCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 4 2008Pierre-François Plouin SUMMARY 1Primary aldosteronism is a condition characterized by renin suppression and various degrees of hypertension and hypokalemia caused by aldosterone hypersecretion. 2The adoption of the aldosterone-to-renin ratio determination as a screening test has led to an increase in the prevalence of diagnosed cases of primary aldosteronism. 3Primary aldosteronism is confirmed by the demonstration of either sustained absolute aldosterone hypersecretion, or non-suppressible aldosterone hypersecretion. 4Computed tomography and adrenal vein sampling can then be used to distinguish between idiopathic primary aldosteronism and the surgically remediable forms: aldosterone-producing adenoma and primary adrenal hyperplasia. 5In patients with aldosterone-producing adenoma or primary adrenal hyperplasia, unilateral adrenalectomy generally results in the normalization of aldosterone secretion and kalemia, but normotension is achieved in only half of the cases. Nevertheless, in many cases without hypertension cure, adrenalectomy leads to an improvement in hypertension control with lower blood pressure levels and/or less antihypertensive medication. [source] | ||||||||||