• Title/Summary/Keyword: Hypertensive Patient's

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The Effect of Public Health Center-Based Hypertension School on Hypertension-related Knowledge, Self-efficacy, Anthropometric Value and Blood Pressure

  • Chang, Koungoh;Kim, Sohee;Lee, Naeyoung
    • International journal of advanced smart convergence
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    • v.7 no.3
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    • pp.44-60
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    • 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.

Patient Compliance and Associated Factors in the Community-based Hypertension Control Program (지역단위 고혈압사업에 있어서 환자의 치료순응도와 결정요인)

  • 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
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    • 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.

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A Study on Hypertensive Patients Compliance to Medical Recommendations (고혈압 환자의 치료지시 이행에 관한 연구)

  • 최영희
    • Journal of Korean Academy of Nursing
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    • v.10 no.2
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    • pp.73-85
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    • 1980
  • 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.

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Recognition of Ginseng by Diebetic and Hypertensive Patients in Daejeon and Geumsan Areas (대전.금산 지역 당뇨.고혈압 질환자의 인삼에 대한 인식도 조사)

  • 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
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    • 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.

Manifest Weeds and Self-Actualization of Patients with Essential Hypertension (본태성 고혈압 환자의 자기실현 및 욕구구조에 관한 연구)

  • 강익화
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.163-180
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    • 1978
  • Much of a person's energy is spent in the effort of becoming a productive member of to-day's complex society. This activity may cause tension, and chronic unrelieved tension is an influential factor in blood pressure elevation. The problem of this study was to identify manifest needs and self-actualization of patients with essential hypertension, and to analyse and compare their manifest needs and selt-actualization with the selected general characteristics of We, sex, religion, occupation and level of education with a control group of patients with normal blood pressure readings. The purpose was to contribute to the planning of nursing interventions toward reducing the impact of complex psycho-somatic factors on the anxiety of patients with essential hypertension. The instruments used included selected items from the Edwards (1959) Personal Preference Schedule (EPPS) as adapted by Hwang (1965) and from the Personal Orientation Inventory (POI) (Shostrom 1964, 1974) adapted by Kim and Lee (1977) to measure manifest needs and self-actualization. The convenience sample was chosen from 149 persons who presented themselves for general physical examinations at Ewha University Medical Centre and 41 patients diagnosed with essential hypertension at three general hospitals in Seoul during June 1 and August 31, 1977. Forty-nine persons from the Ewha group with blood-pressure readings exceeding 150/90 were added to the experimental group. Data were analysed by the S.P.S.S. computer programme using t-test and tests for statistical significance. Statistically significant findings were as follows: A. Blood Pressure and Manifest Needs. 1. with the exception of Autonomy, patients with hypertension had significantly high scores on all variables Abasement, Achievement, Affiliation, Aggression, Dominance, Emotionality, Exhibitionism and Sex. 2. When mean scores of normal persons were compared by age groups, normal persons had higher scores in the following order on Abasement (50's, 40's, 20's, 30's), Achievement (50's, 30's, 40's, 20's), Affiliation (50's, 40's, 30's, 20's), Dominance (50's, 40's, 40's, 20's) and Exhibitionism (30's, 50's, 40's, 20's). In each case, there was a significant difference between the first and last age group scores. 3. When the mean scores of normal persons were compared by sex, normal men had higher scores than women on Achievement, Affiliation, Aggression, Dominance, Exhibitionism and Sex. Male patients had higher scores than female patients on Achievement, Dominance, Exhibitionism and Sex, but female patients scored higher in Emotionality. 4. Normal persons had higher scores related to religion in the following order on Achievement (Buddhism, no religion, Christianity). Hyper tensive patients had higher scores on. Exhibitionism (no religion, Christianity, Buddhism). 5. Normal persons had higher scores related to occupation in the following order on Achievement and Exhibitionism (unemployed, office workers, teachless, businessmen), Emotionality (office workers, unemployed, businessmen, teacher) and Sex (office workers, unemployed, teachers, businessmen). Hypertensive patients had higher scores on Achievement and Aggression (teachers, businessmen, office worker, unemployed), Dominance and Exhibitionism (businessmen, teacher, of ace workers, unemployed) and Sex (teachers, office worker, businessmen, unemployed). 6. Normal persons had higher scores related to level of edification in the following order on Abasement, Emotionality and Autonomy (secondary school graduation, university). Hypertensive patients had higher scores on Abasement (no education, primary, university, secondary), Achievement (no education, secondary, university, primary) , Dominance (university, no education, secondary, primary), Exhibitionism (university, secondary, no education, primary), and Sex (university, secondary, primary, no education). B. Blood Pressure and Self_Actualization 1, Patients with hypertension had significantly lower scores on all variables. 2. Normal persons had higher scores related to age groups in the following order on Existentiality (20's, 30's, 40's, 50's). Hypertensive patients showed no significantly different scores. 3. Normal women had higher scores than men on Time Competence. Normal men had higher scores on Feeling Reactivity. Male patients had higher scores than women on Self-Actualizing Value and Self-Regard. 4. Normal persons ha 1 higher scores related to religion on spontaneity (Buddhism, no religion, Christianity). Hypertensive patients had higher scores on Time Competence and Nature of Man (Buddhism, Christianity, no religion). 5. Normal persons had higher scores related to occupation in the following order on Existentiality (teachers, office workers, businessmen, unemployed) and Self-Regard (unemployed, office workers, teachers, businessmen). Hypertensive patients showed no significantly different scores. 6. Normal persons had higher scores related to level of education in the following order on Existentiality and Self-Acceptance (university, secondary). Hypertensive patients had higher scores on inner-Director (university, secondary, no education, primary) and Existentiality (university, secondary, primary, no education). Recommendations for nursing interventions with hypertensive patients with emotional problems or low self-actualization were made. 1. The nurse should encourage the patient through her interactions with other members of the medical team to accept counselling and health education. 2. Through her therapeutic interpersonal relationships with the patient, the nurse should help him discover the causes of his emotional tension. 3. Through her health teaching with the family, the nurse should encourage them to participate with the medical team in the patient's therapeutic plan and in providing him with the minimum possible emotional support. 4. Through frequent counselling with the obsessive-thinking and inflexible patient, the nurse should reevaluate the patient's behaviour and her interventions. 5. Seriously ill patients should be given needed reeducation by members of the professional medical team.

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Renal artery stenosis presenting as congenital nephrotic syndrome with hyponatremic hypertensive syndrome in a 2-month-old infant: a case report

  • Dabin Kim;Yo Han Ahn;Hee Gyung Kang;Ji Hyun Kim;Seon Hee Lim
    • Childhood Kidney Diseases
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    • v.27 no.2
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    • pp.117-120
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    • 2023
  • Here, we present the case of a 2-month-old male infant with hyponatremic hypertensive syndrome resulting from stenosis of the right proximal and mid-renal arteries. The patient exhibited nephrotic-range proteinuria, low serum albumin, increased serum creatinine, and elevated renin and aldosterone levels. Doppler ultrasonography and computed tomography angiography revealed decreased vascular flow in the small right renal artery. Following a successful percutaneous balloon angioplasty, the patient experienced a decrease in blood pressure and normalization of serum electrolyte levels within a few days. However, it took 3 months for the proteinuria to resolve completely. This case is significant as it represents the first reported instance of a neonate presenting with clinical features resembling congenital nephrotic syndrome caused by renal artery stenosis that was successfully treated with percutaneous renal angioplasty.

Creatinine and microalbuminuria levels are increased in type 2 diabetic patients with hypertension (고혈압을 동반한 제2형 당뇨병 환자에서의 creatinine과 미세 단백뇨 증가)

  • Kim, Hee-Seung;Song, Min-Sun;Yoo, Yang-Sook
    • Journal of Korean Biological Nursing Science
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    • v.4 no.2
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    • pp.51-58
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    • 2002
  • 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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The Knowledge, Attitude and Practice of Blood Pressure Management from the Patient's Viewpoint: A Qualitative Study (고혈압 환자들의 관점에서 본 혈압관리에 대한 지식, 태도, 실천: 질적연구)

  • Lee, Sok-Goo;Jeon, So-Youn
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.4
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    • pp.255-264
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    • 2008
  • Objectives: This study adopted a qualitative method to explore the layman's beliefs and experience concerning high blood pressure and its management in order to develop a strategy to increase adherence to proper medical treatment. Methods: Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 26 hypertensive patients. The participants were selected according to a BP above 140/90 mmHg (hypertension stage 1), based on the seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-VII). The interviews lasted for approximately 30 minutes (range: 20-60 minutes). The resulting questions were formulated into open-ended questions. The interview questionnaire was composed 17 items to examine non-adherence to treatment and 19 items to examine adherence to treatment. Results: Most participants recognized that the direct cause of high blood pressure was unhealthy behavior rather than inheritance. Thus, the hypertensive patient believed they could recover their blood pressure to a normal level through removing the direct cause of hypertension (weight reduction, diet, exercise) instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural or they are artificial, and they may have side effects, and drugs are not treatment for the root cause of hypertension. Most of the hypertensive patients chose to manage their behaviors as soon as they knew their blood pressure was high. Therefore, we should not divide the subjects into two groups according to their taking drugs or not, but they should be divided into two groups according to their willingness or not to manage their condition. Conclusions: For developing a strategy for an individual approach to hypertension management, we need to develop a client-centered attitude and strategy. That is, we need to tailor our approach to individual cases to avoid generalizations and stereotyping when developing an adherence increasing strategy.

Structural Model on Hypertensive Patient's Lifestyle and Quality of Life (고혈압 환자의 생활양식과 삶의 질에 관한 구조 Model)

  • Lee Jong Ryol;Park Chun Man
    • Health Policy and Management
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    • v.14 no.3
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    • pp.66-96
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    • 2004
  • This study was intended to describe the hypertensive patient's lifestyle and quality of life by creating a hypothetic model on the lifestyle and quality of life and by examining a causeand effect relationship, and to contribute to countermeasures for practicing their lifestyle and improving the quality of life through creating a predictable model. Exogenous variable($\xi$) of hypothetic model in this study composed of a family support, hypertension knowledge, perceived benefit and toughness. Endogenous variable($\eta$) composed of self-esteem, perceived health state, depression, lifestyle and quality of life. There were 6 measured variables for exogenous variable(x). There were 9 measured variables(y) for endogenous variable. Also, there was error variable ($\delta,\;\epsilon$) of an individual. The survey was conducted for 207 hypertensive parents who received an out-patient service for 3 weeks from September 15, 2003 to October 3, 2003 after diagnosing as hypertension from 2 general hospitals in Daegu. As the conformance of hypothetic model in this study, there were $x^2$= 155.81, standard $x^2$ ($x^2$/df)=2.32, GFI=0.003, NFI=0.971, CFI=0.982, and RMSEA=0.080. Generally, the hypothetic model and actual data were well coincided. The higher the hypertension knowledge was(t=6.030), the higher the perceived benefit was(t=9.429), the higher the toughness was(t=2.783), and the higher the perceived health state was(t=2.282), the higher the lifestyle was. However, the degree of depression (t=-0.038), family support(t=1.161), and self-esteem(t=0.518) was not affected. The higher the family support was(t=10.476), the higher the self-esteem was(t=7.244), the higher the perceived health state was(t=6.996), the lower the degree of depression was(t=-2.044), and the higher the practice degree of lifestyle was(t=3.315), the higher the quality of life was. However, the toughness(t=1.672) didn't have a significant influence on the quality of life. It was modified to increase the model conformance and gain a conscious model As the result of model revision, for the model conformance, there were $x^2$= 118.43, standard $x^2$=1.69, GFI=0.923, NFI=0.976, CFI=0.982, and RMSEA=0.078. As the revised model showed the better conformance than hypothetic model, it seemed to be more suitable model. In the revised model, the perceived benefit(t=9.440) affected the lifestyle in the revised model. Then, the lifestyle was influenced by hypertension knowledge(t=6.139), toughness (t=2.757), family support(t=2.078), perceived health state(t=1.962) in the order. As a factor which affected the quality of life, there were the family support(t=l0.46l), self-esteem(t=7.368), perceived health state(t=6.989), lifestyle(t=3.316), toughness(t=2.584), and depression(t=-1.968) in the order. It showed the significant effect.

Status of Hypertensive Patients' Drug-taking in Health Center and Its related Factors (보건소 방문 고혈압환자의 약물복용 실태와 관련요인)

  • 서성희;박재용
    • Korean Journal of Health Education and Promotion
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    • v.15 no.2
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    • pp.23-42
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    • 1998
  • The purpose of this study is to show that, before registration of chronic degenerative diseases and enforcing management system in health centers, the management of hypertension could achieved comprehensively and continuously by knowing the realities of drug-taking and its related factors those who are being cared for in health centers. For one year, a questionnaire about drug-taking realities of hypertensive patient was distributed at 8 health centers in Taegu from March 24. 1997 to April 24. 1997. The questionnaires were then collected and analysed. The results are as follows: Of 691 patients, 77.4% of patient were taking medicine regularly every day. The reasons why patients weren't taking medicine every day was as follows: the blood pressure became normal(34%, the highest of the group), patients forgot(28.2%), it was difficult to buy the medicine(15.4%), there was no effect even though the patient took medicine continuously. The experience of medical treatment outside of health centers was 28.9%. The types and percentages of alternative medicine are herbs (50.5%), health food(24.5%), folk remedy(13.7%). Among them, 44.6% of patients didn't know if the medicine was effective. Medical treatment places excluding health centers was pharmacies(63.5%-the highest rate). In simple analysis, the older one was the more regularly one took the medicine, but there was no statistical relations. Of health activities, patients eating low-salt diet showed that they took the medicine regularly. Nonsmoking patients and those who experienced drug side-effect and those who doubted doctor's prescriptions and instructions showed that they took alternative, excluding modem medicine. Anti-hypertensive drug medication status according to recognition, attitude, experiences of hypertension showed that patients who thought that they should take anti-hypertensive drug during the whole life time took the medicine regularly(82.3%). The reasons for patients turning to alternatives varied. In case of having subjective symptom(34.1%), those who thought they knew the hypertension well(36.6%), they decided to use alternatives. In multiple logistic regression analysis the key statistics were as follows: The older patients, patients who ate low-salt diet, patients who thought that they should take anti-hypertensive drug during the whole life time, all showed that they took medicines regularly. And also patients who experienced drug side-effect, doubted prescriptions and instructions, and patients who had subjective symptoms, patients who thought that he knew the hypertension very well, all showed higher rate of using alternative medicine. In the future, at the health centers, to register and manage hypertension patients effectively, we must educate patients about regular drug-taking, and alternatives without doctor's prescriptions.

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