Objective : Hemorrhagic stroke (HS) and hypertensive retinopathy are known end organ damage of the brain and eye respectively, with HS having deleterious consequence to the patients. This study is to correlate between hypertensive retinopathy and HS in hypertensive disease. Methods : A control group of hypertensive patients only, and an investigated group of hypertensive HS patients. Fundoscopic examination to determine the grade of retinopathy was performed and then divided into low or high severity hypertensive retinopathy. Clinical and radiological parameter included are demography, vital signs, Glasgow coma scale (GCS) on admission, clot volume, site of clot, Intracerebral hemorrhage (ICH) score and Glasgow outcome scale (GOS). Data were correlated with the severity of hypertensive retinopathy. Results : Fifty patient in the control group and 51 patients in the investigated group were recruited. In the hypertensive HS group, 21 had low severity retinopathy (no or mild retinopathy) accounting for 41.2% and 30 patients had high severity (moderate or severe retinopathy). In the hypertensive patients 49 had low severity and one had high severity (p-value of 0.001). In HS group low severity showed better GCS score of 9-15 on admission (p-value of 0.003), clot volume less than 30 mL (p-value 0.001), and also a better 30 days mortality rate by using the ICH score (p-value 0.006), GOS score of 4 and 5 the low severity retinopathy fair better than the high severity retinopathy (p-value of 0.001), and the relative risk to develop HS in low severity and high severity retinopathy was 0.42 and 29.4, respectively. Conclusion : Hypertensive retinopathy screening could be used as an indicator in hypertensive patient, to evaluate the risk of developing hypertensive HS in the future.
The recurrent intracerebral hemorrhage[ICH] in hypertensive patients is not an unusual event, but the simultaneous occurrence of multiple ICH is rare. A 70-year-old woman presented with bilateral simultaneous hypertensive intracerebral hemorrhages in both thalami. The complaints of the patient were unconsciousness [semicomatose mental state] and quadriparesis Grade II. The patient was managed conservatively. At discharge, the patient was awake [drowsy mental state], but Grade III according to the Glasgow Outcome Score. This paper reviews the clinical relevance, possible etiology, and treatment of bilateral thalamic ICH.
International journal of advanced smart convergence
/
v.7
no.3
/
pp.44-60
/
2018
This study is to identify the effects of hypertension management program at a community health center on the disease-related knowledge, self-efficacy, anthropometric measurements and blood pressure of a hypertensive patient in local community. This study is a quasi-experimental study using nonequivalence control group no-synchronized design in order to verify the effects of the hypertension management program at a community health center on the hypertension-related knowledge, self-efficacy, anthropometric measurements and blood pressure of a hypertensive patient in local community. The result indicated a significant difference between the experimental group and control group in the scores of hypertension-related knowledge (t=-4.25, p<.001), self-efficacy (t=-4.20, p<.001), systolic blood pressure (t=7.70, p<.001) and diastolic blood(t=5.91, p<.001), body weight(t=2.32, p=.026) and abdominal circumference(t=2.17, p=.036). The hypertensive patients' knowledge and self-efficacy were improved, and their weight and abdominal circumference as well as systolic blood pressure and diastolic blood pressure were reduced. Therefore, it was confirmed that multilateral approaches in terms of physical and psychosocial aspects only targeting hypertensive patients were required for managing hypertensive patients in local community.
Kim, Jee;Min, Kyung-Bok;Kwon, Soon-Ho;Han, Dal-Sun;Bae, Sang-Soo
Journal of Preventive Medicine and Public Health
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v.32
no.2
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pp.215-227
/
1999
Objectives: To investigate compliance of hypertension patients using modified Theory of Reasoned Action(TRA). Methods: The data were collected for 7-12 April 1997, by interviewing 190 Hypertension patients in Hwachon, Kangwon-do. The analytical techniques employed include contingency table analysis and logit analysis. Results: 15.1% of patients were unaware of the fact that he/she has hypertension and 11.2% did not know that he/she should take drug. 20.8% of patients took drug continuously, 20.1% had drug intermittently, and 53.1% had never have treatment. In the contingency table analysis, several variables were found to be significantly related to patient compliance. They included variables for attitude towards the consequences of taking drugs, normative beliefs, systolic BP at the enrollment, knowledge of how to take hypertensive drugs, variables for general health behavior and experience with having health worker's home visit. The logit analysis was performed by two steps. first step uses experience with drug treatment of hypertension as the dependent variable, and second step uses continuity of treatment. Included in the predictors that are significantly related to the former analysis are subjected norms produced by combining normative beliefs and motivation to comply, knowledge of how to take hypertensive drugs, and opinion about natural recovery of diseases. The only significant determinant of continuous treatment was knowledge of how to take hypertensive drugs. Conclusions: The results of analysis suggest the usefulness of TRA as a framework for the study of compliance of hypertensive patients. The findings have some practical implication as well. One is that efforts for enhancing compliance should be directed not only patients but also to other persons influencing patient's attitude and behavior. It also suggest that correct understanding of hypertension treatment is essential to perform the appropriate patient role.
Children with congenital cardiac defects associated with high pulmonary artery pressure may die despite accurate surgery. Postoperative mortality and morbidity have been attributed to acute rises in pulmonary artery pressure and resistance. Acute pulmonary hypertensive crisis is defined as a paroxysmal event in which pulmonary arterial systolic pressure rises to or above systemic levels followed by a rapid fall in systemic pressure and a minor pulmonary hypertensive event is defined as an acute rise in pulmonary arterial pressure to more than 80 % of systemic levels but without a fall in systemic pressure. From Oct. 1988 to Jul. 1989, we experienced 23 patients who showed many pulmonary hypertensive crises after operation in the Department of Thoracic and Cardiovascular Surgery, Seoul National University Children\ulcorner Hospital. Their preoperative PAP/SAPs were 53 to 123 %[mean 93.3%] and diagnoses were VSD[7], TAPVR[5], TGA[4], AVSD[3], MS[1], DORV[1], Truncus arteriosus[1], and AP window[l]. There were 9 deaths among 23 patients and they showed many pulmonary hypertensive crisis episodes during postoperative intensive care, which was managed by sedation, hyperventilation, oxygen, and acidosis correction and which decreased after using tolazoline. In view of our experience, we recommend that pulmonary artery pressure should be monitored in congenital heart defected patient with preoperative pulmonary hypertension to confirm and to manage the pulmonary hypertensive crisis accurately and using tolazoline is helpful in the treatment of pulmonary hypertensive crisis.
The purpose of this study was to investigate the compliance behavior of hypertensive patients in light of their health belief model that explains an individual's compliance with health maintenance or getting well. Although there are many effective regimens and treatments for hypertension nowadays. the most important point to be taken to consideration in their behavioral aspect is their compliance with regard to the control of body weight. eating habits as to salt and cholesterol intake. stresses. activity patterns and smoking as related to their life style. The important reasons for the failure in the control of hypertensive patients are the complexity of regimens to be complied to. irregular medication and the life long restrictions in their own life style. The compliance of patients to medical regimens and rocommendations or failure to do so is an essential factor. Accordingly. the degree of the patient's compliance is an important determinant as to the success or failure of hypertension control. The subjects for this study were 187 hypertensive patients selected from admitted and out patients of the medical department at seven University Hospitals in Seoul. Data was collected from Dec. 1, 1979 to Feb. 15, 1980 using the questionaire method and was analysed by the use of means. standard deviations, coefficient of correlations, analysis of variance and multiple regression analysis. The results obtained are as follows A. Of the seven independent variables in light of health belief model. benefit. barrier and severity are closely related to patient's compliance behavior. Therefore these variables could be used as determinants to predict and modify the hypertensive behavior. 1. Benefit is the most important and significant of the variables for explaining the dependent variables. It accounts for the highest variance of patient's compliance. (23.62%) 2. Then taking the former together with barrier. the variance of compliance showed on increase. (26.59%) 3. And with the addition of severity to the first two. the variance of compliance was also increased. (28.l2 %) B. Except for susceptibility all the independent variables such as severity. benefit, knowledge. motivation and barrier are correlated to dependent variable compliance. C. Sex. marital status and religion appeared to have significant influence on the dependent variables. Therefore one could conclude that the more the patients are aware that hypertension is a threat to health. the more they understand the benefit of taking actions to prevent such a threat. and the less they perceive any barrier when taking action. the more compliant they become in following medical regimens and recommendations. Age. marital status and religion played a significant influence to their compliance. Accordingly. the selected structural variables and demographic variables which have influenced sick role behavior of the hypertensive patient must be integrated to teaching and counselling programs for better hypertension control.
Intracerebral hemorrhage[ICH] following aneurysmal rupture is found in 34% of the previous literature. However, hypertensive ICH concurrent with subarachnoid hemorrhage[SAH] due to an aneurysm rupture is very unusual with only four cases, to our knowledge, having been previously reported in the literature. We describe a patient who presented with aneurysmal SAH concurrent with hypertensive ICH and review of the literature.
Kim, Na-Young;Kim, Sung-Hwan;Kil, Ki-Jung;Yeo, In-Seob;Kim, Hyeong-Seon;Song, Ki-Chul;Shin, Eun-Mi
Journal of the East Asian Society of Dietary Life
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v.21
no.2
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pp.167-173
/
2011
Research on recognition, preference, and consumption of ginseng was conducted with the goal of enhancing the consumption of ginseng, and commercializing local ginseng dishes in Geumsan. With help from the Eulji University hospitals in Daejeon and Geumsan, a survey was completed by a group of 200 patients, including 50 diabetic and 50 hypertensive patients from each center. Results based on a patient's residence (p<0.001), and illness (p<0.001), showed that the percentage of outpatient treatments was very high at the center in Geumsan. Based on a patient's residence (p<0.001) and illness, a preference for ginseng was very high in Geumsan. Based on a patient's residence (p<0.01) and illness (p<0.05), the willingness to try new ginseng dishes was stronger at the center in Geumsan compared to the center at Daejeon. Based on residence and illness (p<0.001), hypertensive patients were more enthusiastic towards taking ginseng herbs. Based on residence (p<0.001) and illness (p<0.001), percipience concerning the effects of ginseng was more positive in Geumsan. Based on residence (p<0.001) and illness, the frequency of ginseng herb intake was higher in Geumsan. The research provides the basis for establishing changes in the perception of ginseng, providing accurate information, and promoting ginseng in local economies.
In response to the global coronavirus disease 2019 (COVID-19) pandemic, vaccines were developed and approved quickly. However, numerous cardiovascular adverse events have been reported. We present two adolescent cases who developed a hypertensive crisis following NT162b2 mRNA COVID-19 vaccination. Patient 1 was an 18-year-old male and his systolic blood pressure was 230 mmHg one day after the second vaccine. He was obese. No secondary cause of hypertension other than the vaccine was identified. Patient 2 was an 18-year-old male who complained with palpitation after the first vaccine. His blood pressure was 178/109 mmHg. He had autosomal dominant polycystic kidney disease. Both were treated with continuous infusion of labetalol followed by losartan, and blood pressure was controlled. Patient 2 received second vaccination and his blood pressure did not rise. It is warranted to measure blood pressure in adolescents at high risk of hypertension after NT162b2 mRNA COVID-19 vaccination.
The purpose of this study was to identify clinical characteristics of type 2 diabetic patients with hypertension. The subjects were 209 type 2 diabetic patients who visited at the endocrine center at Kangnam St. Mary's Hospital of Catholic University in Seoul from beginning of March through the end of April in 2001. The patient's clinical laboratory data were assessed at medical record review. The data were analyzed using for t-test, $x^2$ test. The results were as follows: 1) There were no significant differences in age, body mass index, sex, family history of diabetes and oral hypoglycemic agents between hypertensive group and normotensive group, However, percentage of patients receiving insulin treatment was higher significantly in the hypertensive group. 2) Creatinine and microalbuminuria levels were higher significantly in the hypertensive group. However, fasting blood glucose levels were lower significantly in the hypertensive group. There were no significant differences in $HbA_1c$, 2-hour postprandial blood glucose, total cholesterol, triglyceride, high density lipoprotein cholesterol, lipoprotein(a) and blood urea nitrogen between two groups. Our present study supports that Creatinine and microalbuminuria levels were higher significantly in the hypertensive group.
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