• Title/Summary/Keyword: 고혈압 환자

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Mid to Long Term Outcomes of Surgical Treatment for Isolated Coarctation of Aorta (단순 대동맥 축착의 외과적 치료 후 중.장기 결과)

  • Lee, Seung-Cheol;Yoon, Tae-Jin;Park, Jeong-Jun;Song, Meong-Gun;Kim, Young-Hwee;Ko, Jae-Kon;Park, In-Sook;Seo, Dong-Man
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.83-89
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    • 2007
  • Background: The surgical repair of an isolated coarctation of the aorta, without complex cardiac anomalies, has improved, with very good results. However, despite the success of surgical repair, many long-term complications, such as hypertension, re-coarctation and an aortic aneurysm, still exist. Material and Method: Between 1991 and 2006, 50 patients diagnosed with an isolated coarctation of the aorta were reviewed retrospectively. The incidence of re-coarctation and hypertension were compared with respect to age and surgical methods. Result: There were no early & late mortality, or post operative aortic aneurysms. Hypertension developed in 11 patients (22%). A greater number of patients in the child/adult group had hypertension (52.4%) than in the neonate/infant group (0%). With respect to the surgical methods, the patients in the graft interposition group suffered more hypertension (88.9%) than those in the EEEA (extended end to end anastomosis) group (5.3%). Post operative re-coarctation developed in 2 out of the 29 patients (6.9%) in the neonate/infant group and 2 out of the 21 patients (9.5%) in the child/adult group, but without any statistical difference. There were no statistical differences between the operative type-related groups. Conclusion: Even though the surgical outcomes have greatly improved, an isolated coarctation of the aorta still has many long-term problems, such as hypertension and re-coarctation. An isolated coarctation is accepted as a systemic vascular dysfunction, and often progresses to other cardiovascular diseases. Therefore, patients with a coarctation of the aorta have to be carefully followed-up, and aggressive management must be given when required.

The Purpose and background of this study (노인질환에 대한 한양방동시종합검진 결과에 대한 보고)

  • Gwon, Gyeong-Suk;Lee, Tae-Hwan;Song, Jeong-Mo;Kim, In-Seop;Yun, Ho-Yeong;Im, Jun-Gyu
    • The Journal of Korean Medicine
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    • v.15 no.2 s.28
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    • pp.9-27
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    • 1994
  • This study is to analyze of senile disease status and the social problem according to increased old ages, and then to find distributions of old man's diseases and health status efficiency of oriental-occidental contemporary health examination. And it is the first oriental-occidental contemporary health examination of old man performed by JeonJu Woosuk University Oriental Medicine Hospital and Woosuk-Clinic in nation. Methods The objects in this research are 641's old man of KimJe Gun's over 60's years performed medical examination at JeonJu Woosuk University Oriental- Mmedicine-Hospital and Woosuk-Clinic by oriental-occidental medical contemporary exam., from 1994, 24th June till 1994. 13th July. The 1st occident medical examination methods were consisted of chest x-ray check. blood and urine exam., measurement of blood pressure, visual power and audiometry. The Oriental medical examination methods were consisted of four diagnostics (望,聞,問,切), present illness. chief complaint, past history, families history, social history by question and SA Sang constitution test index. The results and conclusions The results and conclusions are the next: 1. In order of distribution. the athletic disease (75.8%),the digestive disease(43.4%), the circulatory disease(41.5%), the respiratory disease(22.3%), EENT disease(8.1%), the endocrinopathy(5.6%), and the genito-urinary disease(5.3%) are the results of the object about 641's old man, by the oriental-occidental medicine's contemporay exam. 2. Distribution of disease distiction are lumbago. gastritis and peptic ulcer. knee joint pain. heart disease. hypertension. chronic bronchitis. asthma. anemia. DM. Tbc. visual disturbance. CVA. etc in order. 3. Disease distribution according to age is almost high incident in 60-75years. Disease incidence is decreased except E.E.N.T disease in over 76years. 4. The relationships of disease and family history are: the 25.0% of CVA pts. has family history and the 11.6% of hypertension pts has family history. so they showed high relative family history. In addition the 5.6% of TBC pts. and the 2.6% of DM pts. have family history. 5. The relationships of disease and drinking are: Drinking proportion is the 36.4% in respiratory disease pts. the 34.7% in hypertension pts. the 33.3% in heart disease pts.. the 28.4% in digestive disease pts.. but because of no surveying drinking amount we can't know the absolut relationships of disease and drinking. 6. The relationships of Disease and smoking are: Smoking proportion is the 44.1% in respiratory disease pts.. the 38.0% in Heart disease pts.. the 29.8% in Hypertension pts.. but because of no surveying of smoking amount. we can't know the absolut relationships of disease and smoking. 7. Distribution of Sasang constitution is : Tae-eum-in 44.8%. So-yang-in 30.7%. So-eum-in 24.6%. Tae-yang-in 0.0%. And disease distribution of Sasang constitution distinction is ; Tae-eum-in has high incidence of circulation disease(50.0%) and respiratory disease(23.1%).So-yang-in has high incidence of athletics disease(77.7%) and EENT disease(12.2%), So-eum-in has high incidence of digestive disease(65.8%). 8. Distribution of abnormal result in occidental medical examination and oriental-occidental contemporal exam result is considerably different. This is the reason of needing oriental medicine exam, for characteristics of Senile. I think that the oriental-occidental contemporary examination in old man is much more effecient than only occident medical examination. This oriental-occidental contemporary examination has many defects because it is the first practice. To participate in the public health program efficiently. I think that we must improve lots of problems and present the model of the oriental-occidental contemporary examination and the project of oriental medicine's for public health.

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Health Behavior Associated with Outpatient Utilization (외래서비스 이용과 건강행태)

  • Shin, Min-Sun;Lee, Won Jae
    • The Journal of the Korea Contents Association
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    • v.13 no.5
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    • pp.342-353
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    • 2013
  • Objectives: It attempted to analyze influencing factors on the utilization of outpatient services which were adopted to predisposing, enabling, and need factors in Anderson model. Methods: The current study analyzed "2007 Korean National Health Nutrition Survey" data, which selected 3,335 people nationwide by proportional systematic sampling. This study analyzed data of persons who used outpatient services in two weeks. It adopted Anderson Model to control contextual factors including socioeconomic factors. The study compared means and fitted logistic regression models and multilevel model. Results: The logistic regression model showed that persons purchased private medical insurance were less likely to use outpatient services than the persons did not purchase private medical insurance. Persons with hypertension and diabetes mellitus, overweight, and problem drinkers were more likely to use outpatient services. Persons with high school graduates or higher in education level and experience of accidents or intoxications were more likely to use outpatient services according to the multilevel analysis of mixed model which treated region as random effect. Conclusion: Higher level of perceived stress increased the probability to use outpatient service than lower level of perceived stress. As number of days a person had exercised increased, the probability to use outpatient service decreased. Overweight and problem alcohol drinking increased the probability of outpatient service use. Further research should be conducted to find more factors influencing outpatient service use.

Clinical Study of Extra-anatomic Bypass (해부외 회로 조성술에 관한 임상적 고찰)

  • Kim Jong Won;Chung Sung Woon
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.377-381
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    • 2005
  • Background: Extra-anatomic bypass was performed in the patient who could not use anatomic bypass due to many causes. The purpose of this study is to evaluate the efficacy of extra-anatomic bypass surgery. Material and Method: We reviewed 31 patients who underwent extra-anatomic bypass surgery at Pusan national university hospital. We analysed the combined diseases, etiologic diseases, symptoms, patency rate and the factors affecting patency rate retrospectively. Result: There were 26 cases of femoro-femoral bypass and 5 cases of axillo-bifemoral bypass among 31 patients. The mean age was 70.23 years. Combined disease were hypertension, hyperlipidemia, and ischemic heart disease in order of frequency. The indications for surgery were disabled claudication, tissue necrosis, rest pain, and a cute ischemia. We analysed the ages, smoking history, hypertension, ischemic heart disease, severity of limb ischemia, and hyperlipidemia as factors affecting patency rate. We could not find any statistical differences between these factors. The primary graft patency rates were $73.65\%$ one year, $73.65\%$ two year, and $65.46\%$ three year respectively according to the Kaplan-Meier method. Conclusion: Nevertheless extra-anatomic bypass has a relatively low patency rate, it has good merits that is less dangerous, simple and easy re-do surgery compared to anatomic bypass. We think that extra-anatomic bypass is one of the good treatment modalities for the high risk vascular patients.

The Effects of Adherence on Hypertension Control among Newly Diagnosed Hypertension Patients (신규 고혈압 환자에서 치료지속성이 고혈압 조절에 미치는 영향)

  • Han, Jin-Ok;Oh, Dae-Kyu;Yim, Jun;Ko, Kwang-Pil;Lee, Hee Young;Park, Jong Heon;Im, Jeong-Soo
    • Health Policy and Management
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    • v.24 no.2
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    • pp.136-142
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    • 2014
  • Background: This study is to research on how hypertension control is associated with adherence in newly diagnosed hypertension patients. Methods: The study is based on 255,916 patients who were diagnosed with hypertension in 2009 and didn't have any previous medical history of hypertension or associated complication for the past year using data collected by National Health Insurance Corporation. Newly diagnosed hypertension patients are divided into two group by visiting medical center numbers (more than 300 days was adherence group, if not non-adherence group). Patients are considered to have successfully controlled their hypertension based on blood pressure measured by health examination. Chi-square test and logistic regression, repeated measured analysis of variance was used to analyze. Results: The relations between adherence and hypertension control show that 1.12 times of patients in adherence group was able to control their hypertension. The additional analysis proves that adherence group are more decreased level of blood pressure than non-adherence group except for patients who are over 70. Comparison of the average of systolic blood pressure and diastolic blood pressure between adherence and non-adherence groups shows that the blood pressure has been significantly among the adherence group. Conclusion: The study proves that constant treatment for hypertension could control the blood pressure and encourages patients to put more effort for persistent treatment. It also shows that hypertension treatment are more effective in younger patients than the elderly and strategies of approaching are different depending on age.

Impact of Health Literacy on Disease-related Knowledge and Adherence to Self-care in Patients with Hypertension (고혈압 환자의 건강정보 활용능력이 질병관련 지식 및 자가간호 이행에 미치는 영향)

  • Son, Youn-Jung;Song, Eun-Kyeung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.1
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    • pp.6-15
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    • 2012
  • Purpose: The purposes of this study were to identify the level of health literacy and to determine its impact on disease-related knowledge and adherence to self-care in adults with hypertension. Methods: This was a cross-sectional, descriptive study in which patients with hypertension were recruited from outpatient hypertension clinics in Seoul, Korea from December, 2009 to February, 2010. A total 186 patients completed series of questionnaires to assess health literacy, disease-related knowledge, and adherence to self-care. Hierarchical linear regression was used to determine whether health literacy was associated with disease-related knowledge and adherence to self-care. Results: Seventy-one (38.2%) and seventy-two (38.7%) patients had inadequate and marginal health literacy, respectively. In hierarchical linear regression, health literacy independently predicted disease-related knowledge (${\beta}$= .43, p < .001) and adherence to self-care (${\beta}$= .37, p < .001) after controlling for age, education level, having a job or not, and body mass index. Conclusion: These findings show that health care providers need to pay attention to patients with hypertension who have inadequate health literacy. Further, it is recommended to develop and implement new strategies for assessing health literacy in clinical practices. Interventions to improve health literacy could promote disease-related knowledge and adherence to self-care in patients with hypertension.

Effects of oral health behavior on remaining teeth in Korean adults older than 45 years with hypertension and diabetes (한국성인의 고혈압, 당뇨 환자의 구강건강행태가 잔존치아 수에 미치는 영향)

  • Lee, Jung-Hwa
    • Journal of Korean society of Dental Hygiene
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    • v.20 no.1
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    • pp.41-51
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    • 2020
  • Objectives: The purpose of this study was to investigate the effects of oral health behaviors of patients with hypertension and diabetic patients on the number of remaining teeth in Korean adults over 45 years of age, furthermore, we also aimed to develop oral health care programs and health promotion for patients with hypertension and diabetes. Methods: Altogether, 1,526 subjects with hypertension and diabetes from the 6th Korean National Health and Nutrition Survey (2013-2015) were analyzed. Results: A multiple logistic regression analysis was performed to determine the effects of oral health behavior and periodontal disease on residual teeth in patients with hypertension and diabetes after adjusting for age. We found 1.53 times the risk of having less than 20 remaining teeth in the group of brushing more than 3 times a day (95% CI: 1.00,2.35, p<0.001), 2.27 times (95% CI: 1.23-4.17, p<0.05) in the group not using the dental floss group 0.05), compared to the group undergoing regular dental check-up (95% CI: 0.93-1.85, p>0.05), compared to the non-smoking group 0.77 times (95% CI: 0.51-1.14, p>0.05), 1.33 times (95% CI: 0.98-1.80, p>0.05) in the drinking group compared to the non-drinking group, in the periodontal disease group, the risk of having less than 20 remaining teeth was 2.19 times higher (95% CI: 1.48-3.24, p>0.001) than in the normal group. Conclusions: As a super-aging society, develops in Korea, the prevalence of hypertension and diabetes will increase gradually. Therefore, an oral health policy should be implemented at the national level for the prevention and treatment of periodontal disease as well as the management of oral health the elderly.

A Study on Health Behaviors and Medication Compliances of Hypertensive Patients in a Rural Area (일 농촌지역 고혈압 환자들의 건강행태와 약물복용 이행도에 관한 연구)

  • Kim, Keum-Ee
    • Research in Community and Public Health Nursing
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    • v.13 no.1
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    • pp.49-56
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    • 2002
  • This study was performed to identify the health behaviors and medication compliances of hypertensive patients in a rural area, from May 1 to July 31. 2001. The subjects were 100 hypertensive patients who were registered at the Health Center in Goeje City. The data was collected by face-to-face interviews with a 25-item questionnaire on health behaviors, and analyzed by the Chi-square test on each variable. The results were as follows: Approximately 76% of the subjects were currently taking drug medication. In the comparison of health behavior rates between male and female, there were statistically significant differences in smoking (p< .000), alcohol(p< .003), low salt diet(p< .014), and the health behavior rates of female were higher than those of male. In the comparison of socioeconomic factors by medication compliance, there was statistically significant difference in sex(p< .001), and the medication compliance rate of female was higher than that of male. In the comparison of subjects' perception by medication compliance, there were statistically significant differences in seriousness of hypertension (p< .001) and medication period for hypertension care (p< .004), The medication compliance rate of the group of subjects who took the threat on their hypertension seriously was higher than that of the group who didn't, and the medication compliance rate of the group who knew that they should take medication for the rest of their life was higher than that of the group who didn't. These results suggest that community health education programs and distribution of information must be emphasized in order to increase medication and to encourage behavior changes for promoting health.

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Influencing factors from the Transtheoretical Model on the Execution of Self-Management Behaviors among Community-Residing Older Adults with Hypertension (범이론 모형에 근거한 재가 고혈압 노인환자의 자기관리 행위 실천 영향요인)

  • Ahn, Yang Heui;Lim, Young Mi;Kim, KiYon;Kim, Ki-Kyoung;Song, Hee-Young
    • Journal of Korean Public Health Nursing
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    • v.30 no.1
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    • pp.105-121
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    • 2016
  • Purpose: This study examined the influencing factors from the Transtheoretical Model on the stage of change in the self-management behaviors, i.e. regular physical activity and diet, among community-residing adults with hypertension in a rural area. Methods: With a cross-sectional descriptive design, 134 adults who had registered and received a prescription for hypertension medication from a public health center in W city were recruited using convenient sampling. The instrument was an interviewer-administered questionnaire on the stage of change, process of change, self-efficacy, and decisional balance of physical activity and diet. The data were analyzed using descriptive statistics, 2-sample t-test, ${\chi}^2$ test, and logistic regression. Results: The results revealed significant differences in the process of change, self-efficacy, and decisional balance of physical activity and diet between those who were in the pre-execution stage (precontemplation, contemplation, preparation) and those who were in the execution stage (action and maintenance). Logistic regression showed that consciousness raising and self-efficacy were significant predictors of the execution stage in physical activity, and self-reevaluation, social liberation and self-efficacy were significant predictors in the diet. Conclusion: The relevant processes of change, differentiated according to the stage of change, along with self-efficacy, should be addressed to enhance the execution of self-management behaviors among hypertensive adults residing in the community.

The Relationship of Stress Perception with Serum Cholesterol in Patients with Essential Hypertension (본태성 고혈압 환자들에서 스트레스지각과 혈청 Cholesterol 간의 관계)

  • Kim, Sang-Jun;Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.35-44
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    • 1993
  • This study was aimed at investigating the relationship of stress perception and psychopathology with biological variables such as systolic and diastolic blood pressure. serum total cholesterol high density lipoprotein and triglyceride in 50 adult patients with essential hypertension and 50 normotensive individuals. Both of the groups were matched to each other regarding age, sex, the level of education and BMI(body mass index). Stress perception and psychopathology between the two groups were compared using GARS and SCL-90-R scales. Biological variables such as blood pressure(systolic. diastolic), serum total cholesterol, high density lipoprotein and triglyceride were measured in all the subjects. The results were as follows ; 1) Hypertensive patients scored significantly higher than normotensive individuals in stress perception related to unusual happenings, change or no change in routine and overall global area, respectively. 2) Regarding psychopathology, hypertensive patients scored significantly higher than normotensive individuals in depression. hostility and interpersonal sensitivity. respectively. 3) Systolic blood pressure had a significantly positive correlation with scores of stress perception related to sickness and injury, and change or no change in routine, respectively. Diastolic blood pressure had a significantly positive correlation with scores of stress perception related to change or no change in routine. 4) In hypertensive patients. the level of serum total cholesterol had a significantly positive correlation with scores of stress perception related to unusual happenings. However, the level of serum triglyceride had a significantly negative correlation with scores of stress perception related to changes in relationships, sickness or injury, and change or no chang in routine. 5) There were no significant correlations between scores of stress perception and biological factors in the normotensive group. 6) The level of serum triglyceride correlated negatively with phobic anxiety in hypertensive group. whereas it correlated positively with PSDI in normotensive group. In conclusion, these results suggest that hypertensive patients have higher level of stress perception and psychopathology than normal individuals. In hypertensive patients, their stress perception is suggested to be correlated with serum cholesterol.

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