• 제목/요약/키워드: Hypertensive patient

검색결과 93건 처리시간 0.03초

고혈압 환자에서 경락도인태극권의 혈압강하 효과 (Antihypertensive effect of Meridian Tai Ji exercise treatment in hypertension patients)

  • 신미숙;한창현;강경원;최선미
    • 한국한의학연구원논문집
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    • 제14권1호
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    • pp.67-72
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    • 2008
  • Objectives : The purpose of the study was to determine the effects of a 4 weeks Meridian Tai Ji exercise treatment on blood pressure reducing in hypertensive patients. Methods : We measured the blood pressure of 3 patients who were visited in the Gwacheon Health center from 21th November 2007 to 17th December 2007. Eligible participants had systolic blood pressure ${\geq}$ 120 mmHg or diastolic blood pressure ${\geq}$ 80 mmHg with antihypertensive drug. Blood pressure measurements were after the patient had been in rest for at least 10 minute. Twelve sessions of Meridian Tai Ji exercise treatment over 4 weeks were performed in the patients. Blood pressure were measured twice before and after each session. Results : After 4 weeks, blood pressure reduction was observed in the treatment patients, with an average decline of systolic blood pressure up to 5.67 mmHg and diastolic blood pressure up to 0.17 mmHg. But, it was not statistically significant. Blood pressure increased between measurements taken before and after an Meridian Tai Ji exercise treatment session, although individual responses were quite variable. No significant difference was found in the immediate effect. Conclusion : Twelve sessions of Meridian Tai Ji exercise treatment do not seem to control hypertension. Further research is required to determine whether Meridian Tai Ji exercise treatment can enhance clinical management of hypertension if it is used in combination with more enrolled participants, over longer periods, or randomized controlled trial.

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고혈압 환자에서 화침법(和針法)의 혈압강하 효과 (The Depressive Effect of Hwa-acupuncture Treatment in Hypertension Patients)

  • 한창현;박경호;신미숙;신선화;최선미
    • Journal of Acupuncture Research
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    • 제23권6호
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    • pp.165-176
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    • 2006
  • Objectives : Aim of this study was to investigate the antihypertensive effect of Korean Hwa-Acupuncture in hypertensive patients. Methods: We measured the blood pressure of 14 patients who were admitted in the Oriental Medical Clinic of Balance & Harmony Korean Acupuncture Association from 25th March 2006 to 21th July 2006. Eligible participants had systolic blood pressure ${\geq}120mmHg$ diastolic blood $pressure{\geq}80mmHg$. Blood pressure and pulse rate measurements were after the patient had been bed rest for at least 30 min. 10 times of Hwa-Acupuncture treatment over 3 weeks period were performed in the patiants. To evaluate the effect of the Hwa-Acupuncture, the blood pressure, pulse rate were measured 2 times before and after each acupuncture treatment for total of 10 times. Results : After 3 weeks, there were significant decreased in the systolic blood pressure(P<0.0297) and significant decreased in diastolic blood pressure(P<0.0223) treated by Hwa-Acupuncture 10 times but pulse rate was failed to decreased. The effects of Hwa-Acupuncture by measuring time on blood pressure were as follows : systolic blood pressure were deceased significantly from 1st to 10th visit (P<0.0207) but diastolic blood pressure and pulse rate was not decreased significantly. Conclusion : The results suggest that Hwa-Acupuncture is effective in decreasing the systolic blood pressure.

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국내 임상한의사의 고혈압 한방치료 인식 및 실태조사 (A Study on the Recognition and Actual Condition of Korea Medical Doctors in Oriental Medical Care of Hypertension)

  • 신미숙;한창현;김보영;김기진;박선희;최선미
    • Journal of Acupuncture Research
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    • 제25권6호
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    • pp.23-33
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    • 2008
  • Objectives : The study was accomplished to find out how korean medical doctor take oriental medical service for hypertension patients in clinical practice Methods : Survey questions were developed based on consensus of 2 clinician, 2 oriental internal medicine specialist and 1 acupuncture specialist. The list of the Korean oriental medical doctors is provided by the Association of the Korean Oriental Medicine. The questionnaire were distributed via E-mail to 9,465 members of Korean oriental medical doctors from 19th August 2008 to 11th September 2008. One thousand sixty three(11.24% of 9,465) members completed answer and the computerized data were analyzed by SAS statistical program Results : Fifty-one percent of Korean oriental medical doctors has experienced hypertension treatment. The most common medical diagnosis method was pattern diagnosis(64.2%). Saam and five element acupuncture were as frequent as 32.3% of acupuncture prescription principle. The most common acupuncture points were region of shoulder and back acupoints inclued $GB_{21}$, $GV_{14}$(25%). The most common herbs prescription principle were 'constitution prescription'(35.4%), 'pattern prescription'(12.6%). The most common opinion for the revitalization of oriental medical service were 'medical insurance system of herbal medicine'(28.8%) and 'research of oriental medical treatments in hypertensive patients'(26.8%). Conclusions : This survey provides unique insight into the perception, treatment method of the Korea medical doctor at oriental medical service for hypertension patient. This study provides a wealth of information and a fresh raft of questions which will inform future research and policy-making.

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A Case of Infantile Nephrotic Syndrome associated with Neuroblastoma

  • Kim, Soo Hyun;Park, Hyun-Min;Lee, Joo Hoon;Kim, Hyery;Go, Heounjeong;Kim, Dae Yeon;Park, Young Seo
    • Childhood Kidney Diseases
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    • 제22권2호
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    • pp.91-96
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    • 2018
  • Nephrotic syndrome in the first year of life, characterized by renal dysfunction and proteinuria, is associated with a heterogeneous group of disorders. These disorders are often related to genetic mutations, but the syndrome can also be caused by a variety of other diseases. We report an infant with nephrotic syndrome associated with a neuroblastoma. A 6-month-old girl was admitted with a 10% weight loss over 10 days and nephrotic-range proteinuria. She was ill-looking, and her blood pressure was higher than normal for her age. Her cystatin-C glomerular filtration rate was decreased, and levels of plasma renin, aldosterone, and catecholamines were elevated. Renal ultrasonography and abdominal computed tomography showed a retroperitoneal prevertebral mass encasing both renal arteries and the left renal vein. The mass was partially resected laparoscopically, and the pathologic diagnosis was neuroblastoma. Findings on a simultaneous renal biopsy were unremarkable. The patient was treated with chemotherapy and several anti-hypertensive drugs, including an alpha blocker. Two months later, the mass had decreased in size and the proteinuria and hypertension were gradually improving. In an infant with abnormal renin-angiotensin system activation, severe hypertension, and nephrotic-range proteinuria, neuroblastoma can be considered in the differential diagnosis.

고혈압 환자에서 곡운침법의 혈압강하 효과 (Gogoon acupuncture for hypertension)

  • 한창현;송태원;신미숙;신선화;최선미
    • Korean Journal of Acupuncture
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    • 제24권1호
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    • pp.27-41
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    • 2007
  • Objectives : The aim of this study was to investigate the antihypertensive effect of Korean Gogoon Acupuncture in hypertensive patients. Methods : We measured the blood pressure of 17 patients who were admitted in the Oriental Medical Clinic of Gogoon Institute from 14th April 2006 to 29th August 2006. Eligible participants had systolic blood pressure ${\geq}120$ mmHg or diastolic blood $pressure{\geq}80$ mmHg. Blood pressure and pulse rate measurements were after the patient had been in bed rest for at least 30 min. Six sessions of Gogoon Acupuncture treatment over three weeks were performed in the patients. Blood pressure and pulse rate were measured twice before and after each acupuncture treatment. Results : After 3 weeks, there were significant decreases in systolic blood pressure(p=0.0028), diastolic blood pressure (p=0.0111) and pulse rate (p=0.0150). The effects of Gogoon Acupuncture by measuring time on blood pressure were as follows : In a systolic blood pressure (p<.0001) and diastolic blood pressure (p=0.0028) was gradually deceased significantly from 1st to 6th but pulse rate was not significantly decreased. Conclusions : Controlled trials investigating the efficacy of Gogoon acupuncture for lowering blood pressure are warranted.

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지역사회 고혈압환자 영양교육의 효과 평가 (Evaluation of the Effectiveness of a Nutrition Education Program for Hypertensive Patients at the Community Level)

  • 임경숙
    • 대한지역사회영양학회지
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    • 제5권4호
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    • pp.654-661
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    • 2000
  • Hypertension is the major risk factor for cardiovascular disease which is considered the leading cause of death in Korea. Since nonpharmarologic dietary intervention is recommended as the first step in the management of hypertension, evaluation of intervention programs is needed to formulate strategies for improving patients' dietary adherence. This study was designed to evaluate the overall effectiveness of a hypertension nutrition education program (HNEP) at a public health center, by assessing changes in nutrition knowledge, food attitude, self-efficacy, dietary behavior, and nutrient intake after program completion. An HNEP was conducted in Suwon city for 5 months in 1999 by a public health center. The program provided 3 sessions of group education with individual nutrition counseling. Thirty-five patients participated fully in the program out of 62 enrollees. Data about nutrition knowledge, food attitude, self-efficacy, dietary behavior, and intake (24-hour recall) were collected before (baseline) and after the program. Post program results indicate the following : 1) nutrition knowledge and perception of importance of nutrition significantly increased, 2) food attitudes also improved, 3) the self-efficacy for maintaining a low salt diet was increased significantly, whereas self-efficacy for maintaining a low fat diet or dietary guidelines was not improved, 4) frequency of intake of processed food, animal fat, and sweets as well as frequency of dining out were significantly reduced, 5) nutrient intake was not improved after the program, 6) the most serious barrier for participating in the program and practicing diet therapy was lack of time and willingness. In conclusion, it appears that HNEP might improve food attitudes, individual perceptions and self-efficacy for desirable eating behavior, but it might not improve dietary intake. It follows then, that a long term intervention program may need to increase effectiveness of patient dietary adherence.

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A Case-Control Study on the Predictors of Neonatal Near-Miss: Implications for Public Health Policy and Practice

  • Johnson, Avita Rose;Sunny, Sobin;Nikitha, Ramola;Thimmaiah, Sulekha;Rao, Suman P.N.
    • Neonatal Medicine
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    • 제28권3호
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    • pp.124-132
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    • 2021
  • Purpose: Neonatal near miss (NNM) allows for the detection of risk factors associated with serious newborn complications and death, the prevention of which could reduce neonatal mortality. This study was conducted with the objective of identifying predictors for NNM in a tertiary hospital in Bangalore city. Methods: This was an unmatched case-control study involving 120 NNM cases and 120 controls. NNM was determined using Pileggi-Castro's pragmatic and management criteria. Data was collected from in-patient hospital records and interviews of postpartum mothers. Multiple logistic regression of exposure variables was performed to calculate adjusted odds ratio (AOR) with 95% confidence interval (CI). Results: Significant predictors were maternal age ≥30 years (AOR, 5.32; 95% CI, 1.12 to 9.29; P=0.041), inadequate antenatal care (ANC) (AOR, 8.35; 95% CI, 1.98 to 51.12; P=0.032), <3 ultrasound scans during pregnancy (AOR, 12.5; 95% CI, 1.60 to 97.27; P=0.016), maternal anaemia (AOR, 18.96; 95% CI, 3.10 to 116.02; P=0.001), and any one obstetric complication (hypertensive disorder in pregnancy, diabetes in pregnancy, preterm premature rupture of membranes, prolonged labour, obstructed labour, malpresentation) (AOR, 4.34; 95% CI, 1.26 to 14.95; P=0.02). Conclusion: The predictors of NNM identified has important implications for public health policy and practice whose modifications can improve NNM. These include expanding essential ANC package to include ultrasound scans, ensuring World Health Organization recommendations of eight ANC visits, capacity building at all levels of health care to strengthen routine ANC and obstetric care for effective screening, referral and management of obstetric complications.

The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD): A Korean Chronic Kidney Disease Cohort

  • Oh, Kook-Hwan;Park, Sue K.;Kim, Jayoun;Ahn, Curie
    • Journal of Preventive Medicine and Public Health
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    • 제55권4호
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    • pp.313-320
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    • 2022
  • The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) was launched in 2011 with the support of the Korea Disease Control and Prevention Agency. The study was designed with the aim of exploring the various clinical features and characteristics of chronic kidney disease (CKD) in Koreans, and elucidating the risk factors for CKD progression and adverse outcomes of CKD. For the cohort study, nephrologists at 9 tertiary university-affiliated hospitals participated in patient recruitment and follow-up. Biostatisticians and epidemiologists also participated in the basic design and structuring of the study. From 2011 until 2016, the KNOW-CKD Phase I recruited 2238 adult patients with CKD from stages G1 to G5, who were not receiving renal replacement therapy. The KNOW-CKD Phase II recruitment was started in 2019, with an enrollment target of 1500 subjects, focused on diabetic nephropathy and hypertensive kidney diseases in patients with reduced kidney function who are presumed to be at a higher risk of adverse outcomes. As of 2021, the KNOW-CKD investigators have published articles in the fields of socioeconomics, quality of life, nutrition, physical activity, renal progression, cardiovascular disease and outcomes, anemia, mineral bone disease, serum and urine biomarkers, and international and inter-ethnic comparisons. The KNOW-CKD researchers will elaborate a prediction model for various outcomes of CKD such as the development of end-stage kidney disease, major adverse cardiovascular events, and death.

고혈압 복합제 복용환자에서 동일계열약물 중복 현황 (Class duplication prescriptions in patients taking fixed-dose combination antihypertensives)

  • 구현지;이지원;최하은;제남경;정경혜
    • 한국임상약학회지
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    • 제32권2호
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    • pp.125-132
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    • 2022
  • Background: Fixed-dose combinations have the advantage of improving patient compliance, but may increase the risk of duplicate prescriptions. As the use of fixed-dose combination antihypertensives increases, it is necessary to investigate the current status of class duplication prescriptions (CDP) in patients taking fixed-dose combination antihypertensives in Korea and to identify factors associated with CDP. Methods: We conducted a retrospective observational study using nationally representative claim data. Hypertensive patients aged 20 years or older taking fixed-dose combination antihypertensives were extracted. Among these patients, patients with CDP were identified. A chi-square test was applied to determine the differences between patients with CDP and non-CDP. The associated factors of CDP were identified through multiple logistic regression. Results: Of the 74,165 patients who were prescribed fixed-dose combination antihypertensives, 426 patients (0.6%) with CDP were identified. The most common antihypertensive class associated with CDP was calcium channel blockers (194 patients, 45.5%), followed by angiotensin II receptor blockers (136 patients, 31.9%). Patients aged 75 years or older (odds ratio [OR] 1.83, 95% confidence interval [CI] 1.02-3.52), chronic kidney disease (OR 4.45, 95% CI 2.15-8.25), chronic heart failure (OR 2.71, 95% CI 1.93-3.72), coronary artery disease (OR 2.22, 95% CI 1.60-3.03) and Medical Aid/Patriots and Veterans Insurance (OR 1.49, 95% CI 1.04-2.07) were significantly associated with increased CDP. Conclusions: The factors associated with CDP were the elderly, comorbidities, and low socioeconomic status. Since CDP can result in negative clinical outcomes, active intervention by the pharmacist is warranted.

대혈관전위증에 대한 동맥전환술 (Arterial Switch Operation for Transposition of G rest Arteries)

  • 이호철;류한영
    • Journal of Chest Surgery
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    • 제29권3호
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    • pp.278-284
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    • 1996
  • 1989년 5월부터 1994년 5월까지 9명의 대혈관전위증 환자에 대해 동맥전환술을 시행하였다. 연령 분 포는 생후 3일에서 90일까지로 평균 30일 (21일)이 었고 환자는 전례 에서 술전 심초음파 검사로 진단되 었 다. 8례는 심실중격결손을 동반한 대혈관전위증이었으며 1례는 심실중격결손을 동반하지 않은 단순대 혈관잔위증 환아였다. 동반기형으로는 동맥관개존이 8례, 심방중격결손이 7El,대동맥축약이 1례였다. 관동백의 분지 형태는 Yacoub type A가 7례 (77 %), Yacoub type D의 형태가 2례 (23 %)였다. 폐동맥 재 건은 Lecompte 술식을 8례 에서 적용하였고 자가심낭편을 이용하였다. 사망율은 55 %였다. 수술후 1 ~2 일내 사망한 3례는 좌심실 기능부전과 발작성 폐동맥 고혈압이 원인이었고, 수술후 2~3주에 사망한 2례는 술후 감염에 의한 폐혈증이 주원인이었다. 평균 추적 기간은 17개월이 었고 추적관찰에는 심초음파 를 이용하였으며 임상적으로 의미 있는 대동맥 판 폐쇄부전이나 폐동맥 판 상부 협착은 발견되지 않았다. 수술에 따르는 여러 위험 요소들(저체중, 장시간의 체외순환, 체외 순환중 과도한 혈희석, 저체온, 술후 용적 부하, 과도한 \ulcorner\ulcorner\ulcorner사용) 중 술후 과도한 강심제를 사용했을 경우에서만 통계학적 유의성을 가지는 위험인자로 나타났다.

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