• Title/Summary/Keyword: hypertension.

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Factors Related to Therapeutic Compliance of Hypertensive Patients in Small and Medium Scale Industry (중소규모 사업장 고혈압환자의 치료순응과 관련요인)

  • Kim, Yang-Mi;Lee, Kyung-Jae;Kim, Joo-Ja;Chung, Chee-Kyung
    • Korean Journal of Occupational Health Nursing
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    • v.11 no.2
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    • pp.91-107
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    • 2002
  • In order to evaluate the factors related to therapeutic compliance of hypertensive patients in small and medium scale industry, the questionnaire survey and the blood pressure measurement were performed on 138 hypertensive patients who were reported to have C or $D_2$ result of hypertension at the workers' periodic health examination from March to November 2001. The contents of questionnaire included the informations of factors related to therapeutic compliance of hypertensive patients such as, age, sex, marital status, income, education levels, scale, occupation, work duration, smoking and drinking habits, exercise, family history, stress and A type personality, employer's concern, organizational culture, health status, awareness, knowledge and attitude toward the needs of hypertension treatment, and experience of health education. The results of the study were as follows: 1. The proportion of those who were compliant to the treatment of hypertension was 41.3% of subjects. Among small scale industry less than 50 employees, the rate of therapeutic compliance group was 27.5% and therapeutic noncompliance group was 72.5%. Among medium scale industry more than 50 employees, the rate of therapeutic compliance group was 60.3% and therapeutic noncompliance group was 39.7%. 2. Among therapeutic noncompliance group, 95.1% of patients were aware of the fact that workers have hypertension, and 77.8% of patients got 6-10 marks of hypertension related knowledge. For health education, 27.2% were experienced and 34.6% said no intention to participate. And for hypertension treatment, 9.9% said no need to get the treatment and 44.4% said have no idea whether get treatment or not. 3. The significant factors related to therapeutic compliance of hypertensive patients in small scale industry were work duration, A type personality(anger), health status, attitude toward the needs of hypertension treatment, and experience of health education. 4. The significant factors related to therapeutic compliance of hypertensive patients in medium scale industry were age, occupation, subjective symptom, attitude toward the needs of hypertension treatment, and experience of health education. In consideration of above findings, it was suggested that in order to improve the therapeutic compliance in small and medium scale industry hypertensives, it be necessary to change attitude, perception, knowledge and treatment of hypertension by various methods such as effective health education and individually consulting programs by occupational health professional.

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Effects of Public Health Center Hypertension Health School Program on Hypertension-related Knowledge, Self-care Behavior, Quality of life and Physiological Parameters in Hypertensive patients (보건소 고혈압 건강교실 프로그램이 고혈압 환자의 고혈압관련 지식, 자가간호행위, 삶의 질 및 생리적 지수에 미치는 영향)

  • Chang, Koung-Oh
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.11
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    • pp.236-247
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    • 2016
  • The purpose of this study was to examine the effects of health program s on hypertension in a public health center located in Y-si. Most interesting were the effects on hypertension-related knowledge, self-care behavior, quality of life, and physiological parameters for hypertensive patients. Nonequivalent control group pretest-posttest design was employed. A total of 48 patients with hypertension living in Y-si were assigned to either the experimental group (n=23) or the control group (n=25). The experimental group was provided with an 8-week health program on hypertension between August 31 and October 23 in 2015. Data were analyzed with SPSS/WIN 21.0 using descriptive statistics, ${\chi}^2$-test, Fisher's exact test, and t-test. The result indicated a significant difference between the experimental group and the control group with respect to the scores of hypertension-related knowledge (t=-3.76, p<.001), self-care behavior (t=-3.33, p=.002), physiological parameters, including systolic blood pressure (t=6.27, p<.001) and diastolic blood pressure (t=4.70, p<.001), total cholesterol levels (t=3.08, p=.003), and Abdominal circumference (t=2.52, p=.015). We conclude that the self-group program on hypertension has a significant effect on the change of hypertension-related knowledge and self-care behavior for hypertensive patients.

Altered Vascular Expression of Nitric Oxide Synthase Isozymes in Hypertension (고혈압에서 혈관 산화질소 합성 동위 효소 발현 변화)

  • 김인광;강대길;이종은;오봉석
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.138-143
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    • 1999
  • Background: The endothelium-dependent vasorelaxation has been largely accounted for by the release of nitric oxide (NO). Three distinct isoforms of NO synthases (NOS) have been characterized, i.e., brain(bNOS), inducible (iNOS), and endothelial constitutive (ecNOS). Although hypertension hasbeen associated with a vascular endothelial dysfunction, changes in the vascular expression of NOS isoforms have not been established. The present study was aimed at exploring the vascular expression of NOS isozymes in hypertension. Material and Method: Two-kidney, one clip (2K1C) and deoxycorticosterone acetate (DOCA)-salt hypertension were induced in rats. The expression of different NOS isozymes in the thoracic aorta was determined by Western blot analysis. The vascular tissue contents of nitrites were measured by colorimetric assay. Result: Arterial blood pressure was significantly higher in experimental groups of 2K1C and DOCA-salt rats compared with their corresponding control rats. The vascular expression of bNOS as well as that of ecNOS was decreased in both models of hypertension. iNOS was not changed in DOCA-salt hypertension, but was also decreased in 2K1C hypertension. The vascular contents of nitrites were significantly decreased in DOCA-salt as well as in 2K1C hypertension. Conclusion: These results suggest that 2K1C and DOCA-salt hypertension are associated with decreases in the vascular expression of NOS isozymes and nitrite contents.

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Dietary Risk Factors Associated with Hypertension in Patients (고혈압 환자의 식이관련 위험요인 분석에 관한 연구)

  • Son, Sook-Mee;Huh, Gwui-Yeop
    • Korean Journal of Community Nutrition
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    • v.11 no.5
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    • pp.661-672
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    • 2006
  • This study was performed to determine the dietary risk factors associated with hypertension. The hypertensive group were composed of 112 hypertensive patients (male 53, female 59) who first visited the hypertension clinic and had been diagnosed as having primary hypertension ($SBP{\ge}140mmHg\;or\;DBP{\ge}90mmHg$). The regular visitors or the subjects on special diets or medical therapies were excluded. The normal group consisted of as subjects (male 41, female 54) matched with age and socioeconomic levels. The subjects having higher intakes (above the 75 percentile) in energy, protein, iron, vitamin A or C showed significantly higher hypertension risk estimated with odds ratio after the covariance factors (age, sex and BMI) were adjusted. More than 2400 mg of sodium (6 g of salt) intake was associated with significantly higher risk of hypertension (odds ratio: 1.773, CI: 1.014-3.014 for $SBP{\ge}140mmHg$; odds ratio: 2.373, CI: 1.359-4.215 for $DBP{\ge}90mmHg$). Hypertensive group showed significantly increased intakes of vegetables and fish and shell fish compared to the normal group. When the vegetable intakes were classified into Kimchi, fresh vegetables and cooked vegetables with seasoning, the hypertensive group was observed as having higher intakes of Kimchi and cooked vegetables with seasoning. The intakes of highest quartile for vegetables (${\ge}327g/day$) (odds ratio: 3.164, CI: 1.740-5.752), fish and their products (${\ge}102g/day$) (odds ratio: 2.756, CI: 1.486-5.109), grains(${\ge}311g/day$) (odds ratio 2.393, CI: 1.186-4.832), meats and their product (${\ge}106g$) (odds ratio: 2.210, CI: 1.225 - 3.987) compared to the lower were significantly associated with the higher risk of hypertension estimated with DBP (${\ge}90mmHg$) after covariance factors were adjusted. In conclusion, our findings confirm that higher intake of energy or sodium are associated with the increased risk of hypertension. Because increased intake of vegetable or fish was associated with the higher risk of hypertension, in contrast with the finding of western countries, choosing or preparation of vegetables or fish with reduced salt is recommended.

Effects of Dietary Approaches to Stop Hypertension Program on Blood Pressure among the Pre-hypertension Group in the Community (지역사회 주민의 고혈압 예방 식이프로그램의 효과 평가)

  • Jo, Heui-Sug;Shim, Jeong-Ha;Jeong, Heon-Jae;Hwang, Moon-Sun;Lee, Hye-Jean;Kim, Myung-Hee
    • Journal of agricultural medicine and community health
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    • v.31 no.3
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    • pp.237-244
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    • 2006
  • Objectives: DASH (dietary approaches to stop hypertension) diet are recommended as first-line therapy for prevention of hypertension individuals with high normal blood pressure. We studied the effects of DASH program on blood pressure among the pre-hypertension group. Methods: To determine the impact of dietary patterns on the control of hypertension we studied the subgroup of 141 participants with systolic blood pressure of 120 to 139 mm Hg or diastolic BP of 80 to 89mmHg, body mass index(BMI) ${\geq}25kg/m^3$ or waist to hip ratio(WHR) ${\geq}0.95$(for man). 0.85(for woman) enrolled in DASH program. Participants were received of education and consulting about DASH every week for 8 weeks. Results: The level of diet to prevention of hypertension and compliance of DASH increased after education. Also, The DASH program significantly reduced systolic BP (from $136.03{\pm}12.40mmHg$ to $126.09{\pm}11.25mmHg$, p< .01) and diastolic BP (from $81.80{\pm}6.32mmHg$ to $76.44{\pm}10.61mmHg$, p< .01). Conclusion: The DASH program effectively lowers BP and may be useful in achieving prevention of hypertension.

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Factors Associated with the Use of Medical Care at Hospitals among Outpatients with Hypertension: A Study of the Korea Health Panel Study Dataset (2010-2016) (우리나라 고혈압 환자의 병원급 의료기관 외래이용 관련 요인: 한국의료패널자료(2010-2016)를 이용하여)

  • Lee, Sumi;Park, Sohee;Kimm, Heejin;Lee, Yongjae;Chung, Woojin
    • Health Policy and Management
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    • v.30 no.4
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    • pp.479-492
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    • 2020
  • Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient's various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32-0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57-0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05-1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30-2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34-2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19-2.11); people having diabetes (OR, 1.81; 95% CI, 1.41-2.32); or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28-8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion: A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension. Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

The Study on Hypertension Cure Rate Management Centering around Wellness Local Community : With GwangJu as a Central Figure (웰니스 지역사회 중심의 고혈압 치료율 관리 방안에 관한 연구 : 광주광역시 중심으로)

  • Yang, Yu-Jeong;Park, Jong-Ho
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.351-361
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    • 2021
  • This study was conducted to identify the factors of hypertension treatment in Gwangju and to establish a hypertension cure rate management plan by using local community health surveys to provide the hypertension cure rate management plan centering around the wellness local community. The research collected 13,714 Gwangju research data among a total of 685,820 local community health surveys of KDCA (Korea Disease Control and Prevention Agency) from 2017 to 2019. Among the data, 2,941 subjects, those with diagnosed hypertension aged over 30, were selected and analyzed through SAS 9.4, SAS Enterprise Miner 15.1. The results are as follows. The differences in hypertension diagnosis cure rate in Gwangju based on the subjects' socioeconomic characteristics were shown in gender, age, marital status, level of educational attainment, economic activity status, and monthly income. The significant differences in hypertension cure rate based on health behavior characteristics were shown in current smoking, monthly alcohol consumption, high-risk drinking, breakfast, recognition of good health level, diabetes and treatment, annual unmet medical needs, and annual health center use. As a result of the logistic regression analysis and interactive decision tree analysis to identify the factors affecting hypertension treatment, the research found that the factors that appear are age, marital status, diabetes and treatment, and annual unmet medical needs. Accordingly, to increase the recognition of the importance of hypertension treatment to people of young ages and not to develop complications, public health-educational effort in Gwangju is needed with an effective preparation plan.

The effect of oral glucose tolerance testing on changes in arterial stiffness and blood pressure in elderly women with hypertension and relationships between the stage of diabetes and physical fitness levels

  • Lee, Jaesong;Park, Wonil;Sung, Eunsook;Kim, Bokbeom;Kim, Nahyun;Park, Saejong;Shin, Chulho;Park, Jonghoon
    • Korean Journal of Exercise Nutrition
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    • v.24 no.4
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    • pp.34-43
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    • 2020
  • [Purpose] The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness. [Methods] A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed. [Results] In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups. [Conclusion] After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.

A Qualitative Study on Management Behaviors about Blood Pressure of Participants in Moxibustion Clinical Trial for Hypertension (고혈압-뜸 임상시험 참여자들의 혈압 관리행동에 대한 질적연구)

  • Moon, A-Ji;Kim, Tae-Jung;Lee, Seoung-Geun;Kim, Nam-Kwen;Lee, Key-Sang
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.543-557
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    • 2012
  • Objectives : The purpose of this study which adopted a qualitative method was to evaluate blood pressure management behaviors of pre- and stage 1 hypertension patients and to provide fundamental data for developing a strategy about proper oriental medical treatment through analyzing factors related to a moxibustion clinical trial. Methods : Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 10 hypertensive patients. The interviews lasted for approximately 50 minutes. 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 instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural and they may have side effects. On future management plan of patients, most of them will continue to keep moxibustion and healthy behavior in the well-controlled blood pressure group. However in the uncontrolled blood pressure group, there was an increasing tendency to begin medication. 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.

Quality Assessment of Hypertension Management of Office-based Physicians in Korea (우리 나라 개원의 고혈압 관리의 질 평가)

  • Cho, Hong-Jun;Lee, Sang-Il
    • Quality Improvement in Health Care
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    • v.4 no.1
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    • pp.36-49
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    • 1997
  • Background : Hypertension is one of the most important risk factors of the cerebrovascular accident and coronary artery disease which are the major causes of mortality in Korea. In Korea, the quality of care provided by office-based physicians has not been evaluated formally. The purpose of this study is to assess the quality of hypertension management of office-based physicians. Method : Self-administered questionnaires were mailed to the office-based physicians with the speciality of internal medicine, general surgery, family medicine, and general practitioners. Among 2,045 physicians, 981 doctors(48.0%) replied the questionnaires. Contents of questionnaires were based on the recommendation from the JNC-V report(the Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure), and included the criteria of diagnosis, treatment, follow-up interval, and other characteristics of physicians(age, sex, type of speciality, and location of practice). Results : Eighty four percent of the office-based physicians made diagnosis of hypertension with less than 3 times of blood pressure measurements. The performance rate of required examination for hypertensives was very low in most items. Rate of fundoscopic examination is the lowest one among them(5.9%). The performance rate of laboratory examination was also low in most items. Internists tended to order more frequent laboratory examinations than any other type of physicians. Only 11.4% of the physicians did appropriate treatments for the mild hypertension case. The antihypertensives selected by the physicians as a first line drug were in the order of beta blocker(26.4%), calcium channel blocker(23.4%), diuretics(23.1%), ACE inhibitors(14.3%). The visit interval for established hypertensives was very short. Proportion of physicians with follow-up interval longer than 4 weeks was only 4.3%. Conclusions : The overall quality of hypertension management of office-based physicians in Korea is very problematic in many aspects. So further investigations to find out the reasons of low quality arid quality of care should be initiated.

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