• Title/Summary/Keyword: essential hypertension

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Relationship Between Leukocytosis and Vasospasms Following Aneurysmal Subarachnoid Hemorrhage

  • Oh, Se-Yang;Kwon, Jeong-Taik;Hong, Hyun-Jong;Kim, Young-Baeg;Suk, Jong-Sik
    • Journal of Korean Neurosurgical Society
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    • v.41 no.3
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    • pp.153-156
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    • 2007
  • Objective : Cerebral vasospasm is a devastating medical complication of aneurysmal subarachnoid hemorrhage [SAH]. Therefore, prompt detection of vasospasms in aneurysmal SAH is important to the clinical outcome of the patient. For better prediction and effective management of vasospasms, identifying risk factors is essential. This study is aimed at evaluating the relationship between clinical hematologic values, especially white blood cell count, and cerebral vasospasms. Methods : A retrospective review was conducted on 249 patients with aneurysmal SAH who underwent surgical clipping [230 cases] or endovascular intervention [19 cases] between 2003 and 2005. The underlying clinical conditions assessed were leukocytosis, fever, hypertension, diabetes, smoking, Hunt and Hess grade, Fisher grade, aneurysm location, and direct clipping versus endovascular intervention. Results : Two hundred forty-nine patients were treated for aneurysmal SAH during this period. We selected 158 patients in Hunt and Hess grade I - III. Cases of infectious conditions, rebleeding and other surgical/clinical complications were excluded. Vasospasms occurred $7.0{\pm}3.1$ days after the onset of SAH. There were several independent predictors of vasospasm : Fisher grade III [p=0.002], fever within two weeks on admission [p<0.001], and a serum leukocyte count >$10.8{\times}10^3/mm^3$ on admission [p=0.018]. Conclusion : This study results indicate that leukocytosis and fever increase the risk of vasospasms. However, other known risk factors, such as hypertension and smoking, were not correlated with respect to predicting of cerebral vasospasm. Monitoring the serum leukocyte count may be a helpful and useful marker of vasospasms after aneurysmal SAH.

Blood Pressure Cuff Bladders Tailored For Koreans (한국인 맞춤형 혈압계 커프 블래더)

  • Hwang, Lark Hoon;Park, Woo Sung;Na, Seung Kwon
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.38C no.9
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    • pp.822-829
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    • 2013
  • Hypertension is one of the most common clinical diseases, with an increasing prevalence globally. Hypertension triggers various harmful consequences and affects multiple organs. Life-long care may be required in some cases. According to the Korea Center for Disease Control and Prevention, the prevalence of hypertension is gradually increasing. A 2011 survey revealed that 28.9% of Korean adults had hypertension. The prevalence rates were slightly higher among men than women. Accurate measurement of blood pressure(BP) is crucial to classify patients, to identify BP-related risks, and to inform correct treatment. For accurate blood pressure measurement, the use of a cuff bladder size appropriate for the mid-upper arm circumference(MUAC) is essential. Incorrect sized cuff bladder is one of the main causes of equipment error affecting sphygmomanometer accuracy. When commercial sphygmomanometers were examined, the cuff bladders differed from the dimensions specified in the ISO 81060-1:2007 standards. Undercuffing is responsible for a spurious overestimation of BP in patients with large arms leading to overdiagnosis of hypertension, whereas overcuffing (that is, use of relatively large cuffs with small arms), may be responsible for an opposite problem, leading to erroneous underestimation of BP levels. The cuff bladder sizes recommended by the American Heart Association(AHA) are an arm circumference(AC) of 17-25 cm for small-sized adults, AC of 24-32 cm for adults, AC of 32-42 cm for normal-sized adults, and AC of 42-50 cm for obese adults. In contrast, the AC of Korean adults ranges from 23-31 cm, belonging to a single type of adult bladder. Three types of bladders are necessary for Korean adults with an AC of 23-31cm. Hospitals often use one or two differently-sized Western cuffs for adult patients, which can yield inaccurate BP determinations. Cuff bladders with dimensions based on anthropometric reference data obtained from Koreans will aid hospitals to measure BP more accurately.

Left Ventricular Remodeling in Patients with Primary Aldosteronism: A Prospective Cardiac Magnetic Resonance Imaging Study

  • Tao Wu;Yan Ren;Wei Wang;Wei Cheng;Fangli Zhou;Shuai He;Xiumin Liu;Lei Li;Lu Tang;Qiao Deng;Xiaoyue Zhou;Yucheng Chen;Jiayu Sun
    • Korean Journal of Radiology
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    • v.22 no.10
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    • pp.1619-1627
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    • 2021
  • Objective: This study used cardiac magnetic resonance imaging (MRI) to compare the characteristics of left ventricular remodeling in patients with primary aldosteronism (PA) with those of patients with essential hypertension (EH) and healthy controls (HCs). Materials and Methods: This prospective study enrolled 35 patients with PA, in addition to 35 age- and sex-matched patients with EH, and 35 age- and sex-matched HCs, all of whom underwent comprehensive clinical and cardiac MRI examinations. The analysis of variance was used to detect the differences in the characteristics of left ventricular remodeling among the three groups. Univariable and multivariable linear regression analyses were used to determine the relationships between left ventricular remodeling and the physiological variables. Results: The left ventricular end-diastolic volume index (EDVi) (mean ± standard deviation [SD]: 85.1 ± 13.0 mL/m2 for PA, 75.9 ± 14.3 mL/m2 for EH, and 77.3 ± 12.8 mL/m2 for HC; p = 0.010), left ventricular end-systolic volume index (ESVi) (mean ± SD: 35.2 ± 9.8 mL/m2 for PA, 30.7 ± 8.1 mL/m2 for EH, and 29.5 ± 7.0 mL/m2 for HC; p = 0.013), left ventricular mass index (mean ± SD: 65.8 ± 16.5 g/m2 for PA, 56.9 ± 12.1 g/m2 for EH, and 44.1 ± 8.9 g/m2 for HC; p < 0.001), and native T1 (mean ± SD: 1224 ± 39 ms for PA, 1201 ± 47 ms for EH, and 1200 ± 44 ms for HC; p = 0.041) values were higher in the PA group compared to the EH and HC groups. Multivariable linear regression demonstrated that log (plasma aldosterone-to-renin ratio) was independently correlated with EDVi and ESVi. Plasma aldosterone was independently correlated with native T1. Conclusion: Patients with PA showed a greater degree of ventricular hypertrophy and enlargement, as well as myocardial fibrosis, compared to those with EH. Cardiac MRI T1 mapping can detect left ventricular myocardial fibrosis in patients with PA.

Exercise Prescription and Dietary Modification for Prevention and Treatment of Chronic Degenerative Disease II. On Arteriosclerosis and Hypertension (성인병의 예방과 치료를 위한 영양과 운동처방 II. 고혈압과 동맥경화에 미치는 영향)

  • 백영호
    • Journal of Life Science
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    • v.9 no.2
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    • pp.231-240
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    • 1999
  • Regular exercise is effective in preventing coronary disease such as angina pectoris and infarction, inside it can lower the blood pressure and aids in weight control and release of stress. Risk factors of arteriosclerosis is hypertension, hyperlipidemia, diabetes, obesity, physical inactivity and excessive smoking. Arteriosclerosis begins at young age worsens with age, particulary in male. For people with risk factors of arteriosclerosis, it is important to prevent arteriosclerosis-related disease with dietary, living pattern and exercise prescription. Dietary fibers promote exercise of the digestive tract and shortens the time food remains inside the digestive tract. It can prevent obesity, hyperlipidemia, arteriosclerosis and colin cancer by blocking the absorption of cholesterol. Various vegetables and sea foods are lichen unsaturated fats and prevent the absorption of cholesterol inside the digestive tract. Essential fatty acids and unsaturated fats which are contained in vegetable oils, promotes metabolism while preventing absorption. In fruits, pectin water-soluble fiber, is present and lowers the level of cholesterol. By consuming foods that low in cholesterol and saturated fats, and rich in unsaturated fats, aliomentotherapy alone can reduce the plasma cholesterol by 10~l5$\%$. For ideal exercise, it should be aerobic with intensity of 60~80$\%$ HRmax, duration of 15~60min/day. The frequancy of 3~6/week is desirable the better exercise prescription is endurance aerobic exercise. To get more effect exercise, exercise consistency is very important.

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A Experimental Study on the Effect of Kami-Daesihotang on Hyperlipidemia & Hypertension (대시호탕가미방(大柴胡湯加味方)이 고혈압(高血壓) 및 고지혈증(高脂血症)에 미치는 영향(影響))

  • Park, Chi-Sang;Park, Chang-Gook;Han, Seung-Dong;Park, Soon-Dal
    • The Journal of Internal Korean Medicine
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    • v.19 no.2
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    • pp.159-184
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    • 1998
  • The aim of the study was the experiment of the effect that Kami-Daesihotang had on the essential hypertension and hyperlipidemia. Rats were orally administered with Kami-Daesihotang for 30days and the constituent of the plasma and serum were analysed at the 10th, 20th and 30th day from the first day of experiment, respectively. The heart rate, blood pressure, plasma renin activity, plasma level of aldosterone, catecholamine, sodium and angiotensin II were measured after an oral administration of Kami-Daesihotang in SHR. In addition, serum levels of total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol and total lipid were measured with cholesterol-fed rats. The results were summarized as following ; 1. Single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang remarkably decreased the blood pressure in SHR. 2. Double-dosage Kami-Daesihotang were recognized as having the effect on the decreased of the pulse rate in SHR. 3. Plasma renin activity was significantly decreasd in SHR after single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang treatment. 4. Double-dosage Kami-Daesihotang considerably reduced the plasma angiotensin level in SHR. 5. Noticeable decreased of plasma norepinephrine level was showed in SHR, after single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang treatment. 6. Single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang noticeable reduced body weight in hyperlipidemia rats which had fed with 1% cholesterol. 7. Single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang had a significantly decreasing effect on serum total cholesterol in hyperlipidemia rats which had fed with 1% cholesterol. 8. Serum triglyceride level was importantly decreased in hyperlipidemia rats which had fed with 1% cholesterol, after single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang treatment. 9. Remarkable decreased of serum low density lipoprotein cholesterol level was found in hyperlipidemia rats which had fed with 1% cholesterol, after single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang treatment. 10. Double-dosage Kami-Daesihotang was showed a significantly decreasing effect on serum total lipid level in hyperlipidemia rats which had fed with 1% cholesterol. 11. Single-dosage Kami-Daesihotang noticeably reduced organ weight of liver, kidney, spleen and testis in hyperlipidemia rats which had fed with 1% cholesterol. Double-dosage Kami-Daesihotang significantly decreased organ weight of liver, kidney and spleen in hyperlipidemia rats. These Findings suggest a possible anti-hypertensive and hyperlipidemic effect of Kami-Daesihotang.

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Prospective Evaluation of the G-protein $\beta$3 Subunit (GNB3) Gene 825T Polymorphism is Associated With Cerebral Infarction in Korean Population (한국인의 G Protein $\beta$3 Subunit유전자의 다형성과 뇌혈관 질환과의 상관성에 대한 연구)

  • Choi Min Hee;Lee Jin Woo;Lee Kyung Jin;Lee Hyo Jung;Rho Sam Woong;Choi Hyun;Cho Ki Ho;Hong Moo Chang;Shin Min Kyu;Kim Young Suk;Bae Hyun Su
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.3
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    • pp.719-727
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    • 2003
  • Background and purpose: Hypertension and obesity has been implicated in the most important risk factors for stroke. The original finding that the G-protein beta3 subunit (GNB3) C825T allele associates with essential hypertension and obesity has been confirmed in several different populations. Hence, our objective was to determine whether the GNB3 C825T polymorphism predicts interindividual variation in stroke. Method: We recruited 361 stroke patients (cerebral infarction, n=278; intracerebral hemorrhage (ICH), n=83) and 199 healthy control subjects. Subjects were genotyped for GNB3 C825T mutation and findings were investigated for association with stroke. Result: The GNB3 T/T type was significantly associated with cerebral infarction prevalence (OR, 1.98; 95% Cl, 1.14-3.46; p=0.015). While, ICH was not found to be significantly associated with GNB3 T/T type (OR, 1.63; 95% ICH, 0.74-3.56; p=0.219). Similarly, no significant association was determined between GNB T/C type, and cerebral infarction (OR, 1.09; 95% Cl, 0.68-1.74; p=0.716), and ICH (OR, 1.14; 95% Cl, 0.59-2.21; p=0.697). Conclusion: In clinical characteristics, this study shows no differences among GNB3 genotypes, that are BMI, WH ratio. hypertension rate, and ischemic heart disease rate, total lipid level, triglycerides level, total cholesterol level, HDL cholesterol level, prothrombine time, with the exception of LDL cholesterol concentrations. However, our subjects showed an inverse relationship between LDL cholesterol level and the risk of cerebral infarction. We have shown that the GNB3 T/T genotype is strongly associated with cerebral infarction. (OR, 1.98; 95% Cl, 1.14-3.46; p=0.015).

Analysis of Acute Ischemic Stroke Patients about Awareness of Hypertension, Diabetes Mellitus and Hyperlipidemia: Three Oriental Medical Centers-Based Prospective Registration Study (급성기 뇌경색 환자들의 고혈압, 당뇨, 고지혈증 인지여부에 관한 분석 : 3개 한방병원기반 전향적 자료등록 연구)

  • Hong, Jin-Woo;Jung, Woo-Sang;Sun, Jong-Joo;Jung, Jae-Han;Moon, Sang-Kwan;Ko, Seong-Gyu;Chen, Chan-Yong;Han, Chang-Ho;Cho, Ki-Ho
    • The Journal of Internal Korean Medicine
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    • v.28 no.2
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    • pp.284-293
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    • 2007
  • Objectives : Hypertension(HTN), diabetes mellitus(DM) and hyperlipidemia(HL) are the most common risk factors of cerebro-vascular attack(CVA). To prevent CVA, early diagnosis (awareness before CVA) of HTN, DM and HL is essential, and for the effective early diagnosis we need to analyze the data of CVA patients concerned with HTN, DM and HL. In this study, we studied characteristics of patients early diagnosed before CVA. Methods : We analyzed the data of 363 patients with acute ischemic stroke from Hanbang Stroke Registry supported by the Ministry of Science and Technology of Korea. Subjects' enrollment was done in the oriental medical hospitals of 3 universities located in the metropolitan region from October 2005 to October 2006. We analyzed all registered data about HTN. DM and HL, for example, how many patients were aware of their HTN, DM or HL before CVA, differences in characteristics of early diagnosed patients, effects of early diagnosis on CAV, etc. Results : Patients aware of their HTN. DM and HL before CVA have more past history and family history about HTN, DM or HL. Early diagnosis rate of HL is lower than HTN and DM, and early diagnosed HL patients were younger and deucated longer than patients who weren't aware of their HL before CVA. These results mean that publicity is the key to promoting early diagnosis rates of HTN, DM and HL. In DM and HL, early diagnosed patients had more SVO type cerebral infarction than patients who weren't aware of risk factors. We can thus see that early diagnosis even affects CVA types. Conclusion : This work helps us to understand the realities and importance of early diagnosis of HTN, DM and HL before CVA. There should be further research, which can contribute to much more improved early diagnosis rates of HTN, DM and HL.

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Normative blood pressure references for Korean children and adolescents (한국 소아 청소년 정상 혈압 참고치)

  • Lee, Chong Guk;Moon, Jin Soo;Choi, Joong-Myung;Nam, Chung Mo;Lee, Soon Young;Oh, Kyungwon;Kim, Young Taek
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.33-41
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    • 2008
  • Purpose : It is now understood that blood pressure (BP) measurement in the routine pediatric examination is very important because of the relevance of childhood BP to pediatric health care and the development of adult essential hypertension. There hasn't been a reference table of BP for Korean children and adolescents up to now. This study was to make normative BP references and to provide criteria of hypertension for Korean children and adolescents. Methods : BP measurements were done on 57,433 Koean children and adolescents (male: 29,443, female: 27,990), aged 7 to 20 years, in 2005. Heights and weights were measured simultaneously. Oscillometric devices, Dinamap Procare 200 (GE Inc., Milwaukee, Wi, USA), were used for the measurements. BPs were measured 2 times and mean levels were gathered for the analysis. Outliers of 2,373 subjects with overweight per height, over +3SD, were excluded for the analysis. For the BP centiles adjusted by sex, age and height, fixed modified LMS method which was adopted from the mixed effect model of 2004 Task Force in NHLBI (USA) was used. Results : Normative BP tables for Korean children and adolescents adjusted for height percentiles (5th, 10th, 25th, 50th, 75th, 90th, 95th), gender (male, female) and age(7 to 18 years) were completed. Height centiles of Korean children and adolescents are available from Korean Center for Disease Control and Prevention homepage, http://www.cdc.go.kr/webcdc/. Criteria of hypertension (95th, 99th percentile) and normal range of BP (50th, 90th) adjusted for height percentiles, age and gender were made. Conclusion : This is the first study to make normative BP tables and define hypertension for the Korean children and adolescents. Reliability and accuracy of Dinamap Procare 200 oscillometer for BP measurements remains debatable.

Effects of Self Care Program on Hypertensive Control in Hypertensive Patient (고혈압환자에게 적용한 자가관리프로그램 중재 효과)

  • Kim, Ok-Ran
    • Research in Community and Public Health Nursing
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    • v.14 no.4
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    • pp.568-578
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    • 2003
  • This study was conducted to estimate the effects of self-care program on knowledge and symptoms related hypertension self-care and physiological index in essential hypertensive patients aged between 35-74 year. The subjects for the experiment group and the control group of this study were 70 men and women selected through random sampling from adults at Sangju Red Cross Hospital in Gyeongsanbuk-do, and the experiment was carried out during the period from the 15th of September to the 30th of April in 2002. This study measured systolic and diastolic blood pressure (SBP, DBP, the mean value of the two measures) and total cholesterol (TC) and surveyed the subjects' diet and life style in relation to hypertension using a self-report questionnaire. In order to study the significance of the effects of self-care program, the author carried out t-test, paired t-test, ANCOVA, chi-square analysis and effectiveness index (EI) analysis. Results of the study are as follows: The experiment group got higher mean scores than the control group in the degree of low sodium intake and the degree of high calcium and high potassium intake, and the difference was statistically significant(P<0.05). The effectiveness index of the self-care program in smoking was 0.797 at the 1st posttest and 0.601 at the 2nd posttest, and in physical activities 0.600 at the 1st posttest and 0.849 at the 2nd posttest. The rate of regular antihypertensive drugs intake of the experimental group was higher than that of the control group. and the effectiveness index of the self-care program was 0.715. The mean score of the systolic blood pressure of the experimental group was lower than that of the control group, and the difference was statistically significant(P<0.05). In conclusion, these findings support usefulness of self-care programs in reducing systolic blood pressure and in promoting self-care related to diet and life style for treating and preventing hypertension.

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The effects of Aroma foot reflexology and foot reflexology on blood pressure, pulse rate and blood lipid level of elderly essential hypertensive patients in a rural area (아로마발반사요법과 발반사요법이 농촌의 본태성고혈압 노인환자의 혈압, 맥박, 혈중지질농도에 미치는 효과)

  • Lee, Hyeon-Soon;Kim, Dong-Oak
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.9
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    • pp.4053-4064
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    • 2012
  • The purpose of this study was to examine the effects of aroma foot reflexology and foot reflexology on blood pressure, pulse rate and blood lipid level of elderly essential hypertensive patients in a rural area. The research method was a non-equivalent control group pretest-posttest quasi-experimental design and the participants were consisted of 71 elderly patients with essential hypertension who were being registered at C health Clinic(G gun, Chungnam province). Here, we compared experimental group I(aroma foot reflexology) 24 persons, experimental group II(foot reflexology) 27 persons and control group(conventional treatment) 20 persons to measure the effect. The data were analyzed with SPSS/WIN 12.0. The systolic blood pressure(p<.05), the diastolic blood pressure(p<.05), and the pulse rates(p<.01) of experimental group I and II after intervening respectively with aroma foot reflexology, and foot reflexology for 6 weeks were significantly decreased than the control group, but the blood lipid level was no significant difference among 3 groups(p>.05). In conclusion, both of aroma foot reflexology and foot reflexology had positive effects to decrease the blood pressure and pulse rates of the elderly essential hypertensive patients in a rural area and would be utilized as a nursing intervention for them.