• Title/Summary/Keyword: 고혈압 환자

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Blood Pressure Reactivity during Nasal Continuous Positive Airway Pressure in Obstructive Sleep Apnea Syndrome (폐쇄성(閉鎖性) 수면무호흡증(睡眠無呼吸症)에서 지속적(持續的) 상기도(上氣道) 양압술(陽壓術)이 혈력학적(血力學的) 변화(變化)에 끼치는 영향(影響))

  • Park, Doo-Heum;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.24-33
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    • 2002
  • Objectives: Nasal continuous positive airway pressure (CPAP) corrected elevated blood pressure (BP) in some studies of obstructive sleep apnea syndrome (OSAS) but not in others. Such inconsistent results in previous studies might be due to differences in factors influencing the effects of CPAP on BP. The factors referred to include BP monitoring techniques, the characteristics of subjects, and method of CPAP application. Therefore, we evaluated the effects of one night CPAP application on BP and heart rate (HR) reactivity using non-invasive beat-to-beat BP measurement in normotensive and hypertensive subjects with OSAS. Methods: Finger arterial BP and oxygen saturation monitoring with nocturnal polysomnography were performed on 10 OSAS patients (mean age $52.2{\pm}12.4\;years$; 9 males, 1 female; respiratory disturbance index (RDI)>5) for one baseline night and another CPAP night. Beat-to-beat measurement of BP and HR was done with finger arterial BP monitor ($Finapres^{(R)}$) and mean arterial oxygen saturation ($SaO_2$) was also measured at 2-second intervals for both nights. We compared the mean values of cardiovascular and respiratory variables between baseline and CPAP nights using Wilcoxon signed ranks test. Delta ($\Delta$) BP, defined as the subtracted value of CPAP night BP from baseline night BP, was correlated with age, body mass index (BMI), baseline night values of BP, BP variability, HR, HR variability, mean $SaO_2$ and respiratory disturbance index (RDI), and CPAP night values of TWT% (total wake time%) and CPAP pressure, using Spearman's correlation. Results: 1) Although increase of mean $SaO_2$ (p<.01) and decrease of RDI (p<.01) were observed on the CPAP night, there were no significant differences in other variables between two nights. 2) However, delta BP tended to increase or decease depending on BP values of the baseline night and age. Delta systolic BP and baseline systolic BP showed a significant positive correlation (p<.01), but delta diastolic BP and baseline diastolic BP did not show a significant correlation except for a positive correlation in wake stage (p<.01). Delta diastolic BP and age showed a significant negative correlation (p<.05) during all stages except for REM stage, but delta systolic BP and age did not. 3) Delta systolic and diastolic BPs did not significantly correlate with other factors, such as BMI, baseline night values of BP variability, HR, HR variability, mean SaO2 and RDI, and CPAP night values of TWT% and CPAP pressure, except for a positive correlation of delta diastolic pressure and TWT% of CPAP night (p<.01). Conclusions: We observed that systolic BP and diastolic BP tended to decrease, increase or remain still in accordance with the systolic BP level of baseline night and aging. We suggest that BP reactivity by CPAP be dealt with as a complex phenomenon rather than a simple undifferentiated BP decrease.

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Factors Influencing Medication Adherence in Hypertensive Patients (일 지역 고혈압 환자의 약물치료 이행의 영향요인)

  • Seo, Yeong-Mi
    • Research in Community and Public Health Nursing
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    • v.21 no.1
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    • pp.82-91
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    • 2010
  • Purpose: The purpose of this study was to identify factors that influence medication adherence in patients with hypertension. Methods: One hundred sixty two patients with hypertension who visited the outpatient clinics of health centers in J City participated in the study. Data were collected through a questionnaire survey done from January 9 to February 25, 2008. To analyze the sample survey data, descriptive statistics, t-test, ANOVA, Scheffe's test, and multiple regression analysis were performed with SPSS/WIN 12.0. Results: Significant factors that affect medication adherence in patients with hypertension were autonomous motivation, competence, health status, and sex. These variables explained 24% of medication adherence (F=12.48, p<.001). Conclusion: The results indicate that in order to improve the medication adherence of patients with hypertension it is important to develop nursing programs that focus on autonomous motivation and competence and to give consideration to differences in health status and sex. Also further studies are needed to confirm autonomous motivation related to health behavior in patients with hypertension.

A Case of Acute Intermittent Porphyria -A case report- (급성 간헐성 포르피리아 1례)

  • Yang, Chang-Heon;Chung, Moon-Kwan;Lee, Hvun-Woo
    • Journal of Yeungnam Medical Science
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    • v.6 no.1
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    • pp.205-211
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    • 1989
  • We report a case of acute intermittent porphyria presenting with variable symptoms and signs such as hypertention, polyneuropathy, syndrome of inappropriate secretion of antidiuretic hormone and cerebral infarction. A 47 year-old female patient entered hospital with abdominal pain followed by generalized seizure. She was diagnosed to have acute intermittent porphyria in consequence of Watson-Schwartz test and ${\delta}$-ALA in 24 hours urine, but died of respiratory failure.

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Case Report of Hypertension Patient by Community Health Practitioner (보건진료소의 고혈압 환자 간호사례)

  • Park, Do Soon
    • Journal of Korean Academy of Rural Health Nursing
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    • v.14 no.1
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    • pp.17-22
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    • 2019
  • Purpose: This study was done to describe a community health practitioner's nursing case study for a hypertension patient. Methods: For this purpose, data were collected through interviews and nursing records. The nursing process was carried out from January to March in 2019. Results: For this patient, blood pressure was checked 5 times and total cholesterol test was performed 5 times over 41 consultations. Even though the patient was 84 years old, he was very interested in health. When the blood pressure and cholesterol level measured by community health practitioner were high, he was embarrassed by the recommendation to get a hospital checkup. After referral to a medical clinic and hospital, he was satisfied with the results of the tests and medical treatment, and constantly practiced daily walking exercise. Conclusion: It is very important for community health practitioners to assess patient symptoms correctly and refer the patient timely to manage complications.

Development of a Self-Management Adherence Instrument for Patients with Hypertension (고혈압 환자의 자가 관리 이행 도구개발)

  • Gwak, Mi-gyeong
    • Journal of Home Health Care Nursing
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    • v.30 no.1
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    • pp.37-47
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    • 2023
  • Purpose: This study aimed to develop an instrument that measured adherence to self-management among patients with hypertension, and to verify the validity and reliability of the developed instrument. Methods: The 34 indicators that underwent the content validity test were provided to 202 subjects for investigation The collected data were analyzed using SPSS Ver. 22.0 and Amos Ver. 25.0. Results: Five factors, 'interaction,' 'lifestyle change,' 'continuing motivation,' 'medical care', and 'weight control' were extracted, and the total cumulative variance was shown to be 61.75%. The test statistic of the regression coefficient was statistically significant according to the confirmatory factor analysis. Conclusion: It is suggested that more research is needed to generalize the instrument to suit more candidates, while continuing to refine the reliability and validity of the instrument.

Cuffless Blood Pressure Estimation Based on a Convolutional Neural Network using PPG and ECG Signals for Portable or Wearable Blood Pressure Devices (휴대용 및 웨어러블 측정기를 위한 ECG와 PPG 신호를 활용한 합성곱 신경망 알고리즘 기반의 비가압식 혈압 추정 방법)

  • Cho, Jinwoo;Choi, Ahyoung
    • Journal of Korea Society of Industrial Information Systems
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    • v.25 no.3
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    • pp.1-10
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    • 2020
  • In this paper, we propose an algorithm for estimating blood pressure using ECG (Electrocardiogram) and PPG (Photoplethysmography) signals. To estimate the BP (Blood pressure), we generate a periodic input signal, remove the noise according to the differential and threshold methods, and then estimate the systolic and diastolic blood pressures based on the convolutional neural network. We used 49 patient data of 3.1GB in the MIMIC database. As a result, it was found that the prediction error (RMSE) of systolic BP was 5.80mmHg, and the prediction error of diastolic BP was 2.78mmHg. This result confirms that the performance of class A is satisfied with the existing BP monitor evaluation method proposed by the British High Blood Pressure Association.

The Effect of Yoga Program on Reduced Blood Pressure in Elderly′s Essential Hypertension (요가 프로그램이 본태성 고혈압 노인환자의 혈압하강에 미치는 효과)

  • 박형숙;김윤진;김영희
    • Journal of Korean Academy of Nursing
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    • v.32 no.5
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    • pp.633-642
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    • 2002
  • The purpose of this study was to evaluate the effect of a Yoga program on decreasing blood pressure in elderly patients with essential hypertension and to suggest a yoga program effective as a nursing intervention tool to reduced blood pressure with increasing life satisfaction. Method: The subjects of this study were 24 elderly's essential hypertension, who practiced yoga by three times a week for 8 weeks. In order to evaluate the effect of the yoga program, blood pressure, physiological parameters (Total cholesterol, HDL, LDL, triglycerides) and level of life satisfaction were measured before and after the training. Collected date were analyzed by SPSSWIN program. Result: 1) There were significant reduction in systolic and diastolic blood pressure. 2) There were significant reductions in total cholesterol, LDL, triglycerides but no significant increased in HDL. 3) Blood pressure changes were time specific : Both of systolic and diastolic blood pressures were significantly reduced after 2weeks. 4) There was a significant increase in life satisfaction. Conclusion: The results proved that a yoga program was an effective nursing intervention to reduce blood pressure and to increased life satisfaction for elderly patients with essential hypertension.

Antihypertensive Effect of Peptide from Sardine Muscle Hydrolyzate on Mild Hypertensive Subjects (정어리 단백질 유래 펩타이드의 경중 고혈압 환자에 대한 강압효과)

  • Kawasaki, T.;Seki, E.;Osajima, K.;Yoshida, M.;Asada, K.;Matsui, T.;Osajima, Y.
    • Proceedings of the Korean Society of Food Hygiene and Safety Conference
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    • 2004.11a
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    • pp.50-58
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    • 2004
  • Valy-Tyrosine (VY) derived from alkaline pretense hydrolyzate of sardine muscles showed the in vitro Angiotensin I converting enzyme (ACE) inhibitory activity and the in vivo antihypertensive effect in SHR. We investigated the antihypertensive effect of the VY on mild hypertensive subjects including subjects with high-normal blood pressure using a randomized double-blind placebo-controlled study. (1) Nineteen subjects (Age 48.9${\pm}$4.3, M/F;18/1) took a 100ml drink either containing 125${\mu}$g of VY or placebo twice daily for 4 weeks. The reductions of the systolic (SBP) and diastolic blood pressure (DBP) were observed in mild hypertensive subjects (n=5) with averages of 17.8${\pm}$2.5 mmHg (p<0.01 vs placebo) and 11.0${\pm}$2.0 mmHg(p<0.05 vs placebo), respectively. Neither SBP nor DBP changed in the subjects of both the placebo group and the high-normal blood pressure group. (2) A randomized double-blind cross-over placebo-controlled study was carried out in 10 mild essential hypertensive subjects (Age 50.6${\pm}$4.6, M/F;10/0). They took a 100ml drink either containing 62.5${\mu}$g of VY or placebo twice daily for 4 weeks alternatively with a 6-week interval. The percent changes in SBP and DBP were -6.9 % and -5.8 % (p<0.05) one week after the VY drink administration, respectively. No adverse effects such as coughing or allergic phenomena could be observed in any of the subjects of drinking VY during the experimental period. These results suggest that the drink containing at least 125${\mu}$g/day of VY may have a significant antihypertensive effect on mild hypertensive subjects without any adverse effects.

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Antihypertensive Effect and Safety of Imidapril on the Patient with Essential Hypertension (본태성 고혈압에 대한 Imidapril의 강압효과 및 마른기침 발현율에 대한 고찰)

  • Hong, Gue-Ru;Bae, Jun-Ho;Jun, Dae-Jin;Park, Jong-Seon;Sin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Sup
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.69-75
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    • 1999
  • Imidapril(Tanatril$^{(R)}$), a newly developed ACE inhibitor, has been used to treat hypertension and congestive heart failure. This study was designed to assess the antihypertensive effect and safety of Imidapril(Tanatril$^{(R)}$) in patients with essential hypertension. 5-10mg of imidapril(Tanatril$^{(R)}$) was administered once a day in 30 patients with essential hypertension and followed up for 8 weeks. We tested the drug's effectiveness, safety, and the incidence of imidapril induced dry coughs. After 8 weeks of treatment with imidapril, 76.2%(16/21) of patients showed lowered blood pressure and 47.6% showed normal blood pressure. The overall incidence of adverse effects was 33.3%(7/21), and among these adverse effects, dry cough was shown in only 9.5%. Thus, we concluded that imidapril(Tanatril$^{(R)}$) is as safe and effective as other ACE inhibitors, especially with imidapril showing very little incidence of dry cough compared to other ACE inhibitors.

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Decision-Tree Analysis to Predict Blood Pressure Control Status Among Hypertension Patients Taking Antihypertensive Medications (약물복용 중인 고혈압 환자의 혈압관리양상 예측을 위한 의사결정나무분석)

  • Kim, Hee Sun;Jeong, Seok Hee;Park, Sook Kyoung
    • Journal of Korean Biological Nursing Science
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    • v.21 no.1
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    • pp.85-97
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    • 2019
  • Purpose: This study was performed to analyze the levels of blood pressure and to identify good or poor blood pressure control (BPC) groups among hypertension patients. The study was based on the Korea National Health and Nutrition Examination Survey (KNHANES VI and VII) conducted from 2013 to 2016. Methods: The sociodemographic and clinical data of 4,151 Korean hypertension patients aged 20-79 years and who were taking antihypertensive medications was extracted from the KNHANES VI and VII database. Descriptive statistics for complex samples and a decision-tree analysis were performed using the SPSS WIN 24.0 program. Results: The mean age was $62.46{\pm}0.21years$. The mean systolic blood pressure (SBP) was $128.07{\pm}0.28mmHg$, and the diastolic blood pressure (DBP) was $76.99{\pm}0.21mmHg$. 71.9% of participants showed normal blood pressure (SBP < 140mmHg and DBP < 90mmHg). From the decisiontrees analysis, the characteristics of participants related to good BPC group were presented with 9 different pathways same as those from the poor BPC group. Good or poor BPC groups were classified according to the patients' characteristics such as age, living status, occupation, education, hypertension diagnosis period, numbers of comorbidity, perceived health status, total cholesterol, high density lipoprotein-cholesterol, alcohol drinking per month, and depressive mood. Total cholesterol level (< 201mg/dL or ${\geq}201mg/dL$ cutoff point) was the most significant predictor of the participants' BPC group. Conclusion: This decision-tree model with the 18 different pathways can form a basis for the screening of hypertension patients with good or poor BPC in either clinical or community settings.