• Journal of Korean Critical Care Nursing
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• v.9 no.2
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• pp.48-60
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• 2016

Purpose: The purpose of this study was to identify the attributes of the concept, of psychological resistance to antihypertensive medication. Methods: The study was conducted in accordance with Walker and Avant's conceptual analysis process. We reviewed 47 related studies selected from 4 international and Korean databases including Medline, CINAHL, NDSL, and RISS to perform the analytical processes from January 1980 to September 2015. Results: The attributes of psychological resistance to antihypertensive medication include 1) reservation, 2) opposition, 3) denial, 4) refusal, and 5) seeking alternative therapy. The antecedents of the concept can be classified into patient factors such as reactance trait and knowledge deficit, provider factors, interpersonal factors, and environmental factors. The consequences of psychological resistance to antihypertensive medication are non-compliance, deterioration of the disease, developing complications, increased anxiety, and changes in life. Conclusions: The concept of psycho logical resistance to antihypertensive medication can provide guidance for the development of an intervention program that promotes the compliance to medication regimen of hypertensive patients. Further research needs to be done to develop a measurement tool for psychological resistance to antihypertensive medication.

• Korean Journal of Family Medicine
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• v.39 no.6
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• pp.325-332
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• 2018

Background: Hypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication. Methods: From August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable. Results: Of the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ${\geq}65$ years, exercise, treatment in a metropolitan-located hospital, being on ${\geq}2$ classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication. Conclusion: Multiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.

• Journal of Preventive Medicine and Public Health
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• v.40 no.3
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• pp.249-258
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• 2007

Objectives : The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. Methods : The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. Results : The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence $(CMA{\geq}80%)$ rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. Conclusions : The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.

• Journal of Preventive Medicine and Public Health
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• v.36 no.3
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• pp.289-297
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• 2003

Objectives : The main objectives of this study are to identify the factors associated with hypertension control and to determine the influencing factors associated with antihypertensive therapy. Methods : The study was conducted on 107 subjects who participated in the 1999 and 2002 Gwacheon Study and who had had uncontrolled hypertension (systolic$\geq$140 or diastolic$\geq$ 90mmHg) in 1999, We compared the characteristics of the controlled and uncontrolled hypertensive group and investigated the characteristics of those taking antihypertensive medication. Univariate associations between hypertension control and its characteristics and the association between antihypertension treatment and its characteristics were tested with $x^2$-test. We also peformed logistic regression analysis. Results : The participants who had their blood pressure checked within 6 months before their first measurement and those who had taken the antihypertensive medication showed significantly better hypertension control during the follow-up. The multivariate analysis showed that baseline antihypertensive therapy was the most important determinant factor of hypertension control during the follow-up. Socioeconomic level and life style did not affect hypertension control when controlled by the treatment variable in this study. The factors associated with antihypertensive therapy at follow-up were previous antihypertensive therapy, old age, and high educational level. Conclusions : Those who received antihypertensive therapy and those who had their blood pressure re-checked within 6 months both showed well controlled hypertension. The subjects with high educational level complied well with the antihypertensive regimen, but those in their forties did not.

• The Korean journal of internal medicine
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• v.39 no.2
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• pp.205-214
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• 2024

Hypertension remains a global health concern because of suboptimal blood pressure control despite advancements in antihypertensive treatments. Chronotherapy, defined as evening or bedtime administration of medication based on biological rhythms, is emerging as a potential strategy to improve blood pressure control and treatment outcomes. Clinical trials have investigated the potential effects of nighttime administration of antihypertensive medication in the improvement of 24 hours blood pressure control and reduction of cardiovascular risk. Implementing chronotherapy in clinical practice could have significant implications in enhancing blood pressure control and improving clinical outcomes in patients with hypertension, particularly those with resistant hypertension. However, recent trials have reported contradictory results, causing confusion in real-world practice. Herein we review, analyze, and critique the current evidence and propose suggestions regarding the clinical application and future directions of chronotherapy.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.93-106
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• 2003

Objectives: This study was conducted to investigate the treatment status and its related factors of the rural hypertensives. Methods: A questionnaire survey was performed to 618 rural hypertensives during September, 2002. Results: The proportion of those who were compliant to the antihypertensive medication was 68.9%. The compliance rate to the antihypertensive medication was significantly related with sex and economic status(p<0.05). That is, if they were female, higher economic level, the regular antihypertensive medication rate was higher. The regular antihypertensive medication rate was higher when they had higher knowledge for hypertension, higher severity for hypertension of him or her(p<0.01). And the compliance rate to the antihypertensive medication was significantly related with hypertensives' own explanatory model for hypertension(p<0.01). The rate of drug use except antihypertensives was 12.5%. The rate of drug use except antihypertensives was higher when they experienced side effects of antihypertensive drug and when they had irregular medication for antihypertensive drug(p<0.01). The rate of medical equipment use was 18.9%. The utilization rate of medical equipment such as jade mat, germanium material was significantly related with age, experience of side effects of antihypertensive drug, medication status for antihypertensive drug(p<0.05). The rate of folk therapy use was 16.2%. The rate of folk therapy use was higher when they had no family, when they had knowledge about hypertension on the average, when they had hypertension over 10 years(p<0.05), and when they experienced side effects of antihypertensive drug and when they had irregular medication for antihypertensive drug(p<0.01). The rates of drug use except antihypertensives, medical equipment use, and folk therapy were significantly related with hypertensives' own explanatory model for hypertension(p<0.05). Conclusions: On consideration of above findings, it would be essential to provide knowledge about hypertension and its treatment, and severity of hypertension complications through health education.

• YAKHAK HOEJI
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• v.58 no.2
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• pp.141-149
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• 2014

Background: Oriental lifestyle for treating diseases has been developed and well-accepted for a long time among Koreans. Sasang Constitution theory, originated from Korean traditional medicine, suggests that medication treatment should be differentiated by each patient's body classification (So-yang [SY], So-eum [SE], Tae-yang [TY], and Tae-eum [TE]), in contrary to western medicine's theory that medication should be applied equally by disease indication without such classification. However, the pharmacotherapeutic outcomes of these theories have not been compared to date. In this study, we aimed to compare the two theories by evaluating blood pressure (BP), which is lowered as a therapeutic outcome, among hypertensive patients taking angiotensin II receptor blockers (ARBs) or calcium channel blockers (CCBs), two most commonly used antihypertensive classes in Korea. Methods: From April 2006 to June 2012, we retrospectively collected data on hypertensive patients with Sasang Constitution classification at Kyunghee University Hospital at Gangdong, one of the East-West collaborative medical centers in Korea. We collected information on age, gender, underlying diseases, antihypertensive drugs (ARB, CCB, ARB+CCB), and BP by reviewing the electronic medical records. We excluded patients with missing blood pressure at baseline or follow-up, or those who had a change in their antihypertensive drug class during follow-up. Results: We selected a total of 573 patients (SY: 165, SE: 158, TY: 0, TE: 250). Baseline BPs were on average 139.0/82.0 mmHg for SY, 137.8/78.5 mmHg for SE, and 138.7/79.2 mmHg for TE. In all three groups, CCBs were the most prescribed, followed by combination therapy with ARB+CCB, then ARBs. BP reduction after 1 month of initial medication was significantly different among the drug classes, but not in Sasang constitutional classification (ARB [SY: -12.4/-4.7, SE: -12.3/-2.5, TE: -8.6/-1.8], CCB [SY: -12.3/-5.4, SE: -13.0/-2.3, TE: -10.8/-6.0], ARB+CCB [SY: -15.6/-6.7, SE: -18.4/-8.1, TE: -20.2/-6.7], drug [$P{\leq}0.05$/P>0.05], constitutional type [P>0.05/P>0.05]). Conclusion: We observed significant differences in reduction of blood pressure by classes of drugs (ARB+CCB>CCB>ARB) but not by Sasang constitutional classification. Therefore, current approach of antihypertensive pharmacotherapy assisted by Western medicine is appropriate for treatment of hypertension. However, further larger scale or prospective studies are required in order to confirm these results.

• The Journal of Internal Korean Medicine
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• v.38 no.4
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• pp.443-454
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• 2017

Objectives: This study assessed the application of Oryung-san (Wuling-san or Gorei-san), a common diuretic in traditional medicine, as an antihypertensive agent. Methods: Experimental studies of the pharmacological properties of Oryung-san, including diuretic action and lowering effects on blood pressure, and toxicology and clinical trials were reviewed. Results: In pharmacology, various, relatively safe diuretics are used to lower blood pressure and are the oldest and most studied antihypertensive agents. Despite many new drug approvals, antihypertensive diuretics are frequently used in Korea and Japan where high levels of sodium uptake are common. Oryung-san has been demonstrated to have diuretic, antihypertensive, and nephroprotective effects. Conclusions: Oryung-san might be effective for lowering blood pressure based on the results of this literature review. Further evaluations and large-scale clinical trials of Oryung-san to treat primary hypertension are warranted.

• Journal of Chest Surgery
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• v.25 no.2
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• pp.200-204
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• 1992

A 63 year old male had suffered from hypertension and angina pectoris for 4 years, On physical examination, blood pressure was 150/110 mmHg with medication of antihypertensive drugs. Aortogram showed the stenosis of the left renal artery, the complete occlusion of the right renal artery, and atherosclerotic change of abdominal aorta. Blood urea nitrogen was 25 mg/dl, serum creatinine was 1.2 mg/dl, and renin activity in peripheral blood was 8.7 ng /ml /hour, The stenosis of left renal artery and the complete occlusion of right renal artery should have produced the renovascular hypertension Bilateral aorto-renal bypasses with saphenous grafts were done for treatment of ren-ovascular hypertension Postoperatively, blood pressure was normalized with only small dosage of antihypertensive drugs.

• Health Policy and Management
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• v.31 no.3
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• pp.292-300
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• 2021

Background: Medication adherence in hypertension is the most important to control blood pressure and prevent major complications. The purpose of this study was to identify factors affecting medication adherence and to examine the relationship between medication adherence and blood pressure control in Korea. Methods: This study used data from the 7th Korea national health and nutrition examination survey (2016-2018) of the Korea Disease Control and Prevention Agency. We selected 4,063 hypertensive patients from the data. And we choose socio-demographic, health behavior, healthcare utilization, and severity characteristics as hypertensive patient characteristics. Results: Of the patients with hypertension, 92.3% had shown adherence to medication as of 2016-2018 and shows variation according to the characteristic of patients. The cases with male, under 50 years old, urban area, single household, unmet medical services, less than 5 years of hypertension duration, no comorbidities (diabetes mellitus, myocardial infarction) showed significantly low medication adherence. After adjusting for confounders, adherent patients tended to have lower current systolic blood pressure (β=-10.846, p<0.001) and diastolic blood pressure (β=-5.018, p<0.001) than nonadherent patients. And, adherent patients increased the control odds of blood pressure compared with nonadherent patients (odds ratio, 3.02; 95% confidence interval, 2.21-4.12). Conclusion: This study confirmed that adherence to antihypertensive drugs was effective in controlling blood pressure. In order to more actively manage hypertensive patients at the national level, it is necessary to make an effort to improve the medication compliance of nonadherent groups, such as early-diagnosis patients, young patients under 50 years of age, and patients living alone.