• 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.

• Journal of Haehwa Medicine
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• v.14 no.2
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• pp.55-70
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• 2005

In oriental medicine, Gamibangpungtongsungsan (KBTS) has been used as a therapeutic agent for the treatments of acute stage of cerebrovascular diseases and hypertension. In the present study, underlying mechanism on KBTS effects was investigated using spontaneously hypertensive rats (SHR) by determining related parameters such as blood pressure, heart-beat rates, and hormones and plasma constituents. The major finding are summarized as follows. 1. KBTS treatment at concentrations lower than $125\;{\mu}g/m{\ell}$ did not show any cytotoxicity on cultured human fibroblast cells. 2. KBTS treatment in SHR significantly decreased blood pressure and heart-beat rate compared with untreated control. 3. KBTS treatment in SHR decreased aldosterone levels in the blood compared with untreated control, but the difference was not statistically significant. 4. KBTS treatment in SHR significantly decreased dopamine, norepinephrine and epinephrine levels in the blood compared with untreated control. 5. KBTS treatment in SHR decreased plasma ion concentrations such as Na+, K+, Ca2+, Cl- compared with untreated control; decreases in Na+ and Cl- were statistically significant. 6. KBTS treatment in SHR significantly decreased TNF-$\alpha$, IL-6, and IL-10 levels in the blood compared with untreated control. Thus, the present data show evidence on anti-hypertension activity of KBTS in an experimental animal system, which can provide further insights into the development of anti-hypertension therapeutic agents.

• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.133-146
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• 2001

The purpose of this study was to investigate the treatment status and its related factors of the newly detected rural hypertensives through community health promotion program. A questionnaire survey and blood pressure measurement were performed to 6,977 residents of a rural area, and 282 hypertensives detected by blood pressure measurement were selected as subjects of the study. The study employed the health belief model as a hypothetical model. The major results of this study were as follows: The proportion of person experienced treatment among hypertensives was 12.0%. Treatment experience rate was significantly related with age and educational level(p<0.01). That is, if they were older, lower educational level, the treatment experience rate was higher. The major reasons of no treatment were 'they had not hypertensive symptoms ' (45.6%), 'their blood pressure was not high so much that they received treatment ' (43.2%). The chief facilities for treatment were public health institutions(57.9%) such as health center and health subcenter, and hospital/ clinics(29.8%). The treatment experience rate was higher when they had higher perceived severity for hypertension, lower perceived barrier to treatment, although statistically not significant. Treatment experience rate was significantly related with cues to action and health education experience(p<0.05). That is, if they had hypertension related symptoms such as headache previously, patients suffered from hypertension complication and health education experience for hypertension, the treatment experience rate was higher. In multiple logistic regression analysis for treatment experience, having a cerebrovascular patient in their acquaintance and the experience of health education for hypertension were significant variables. On consideration of above findings, it would to be essential to provide knowledge about hypertension and its treatment, and severity of hypertension complications through health education.

• The Korea Journal of Herbology
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• v.30 no.4
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• pp.129-135
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• 2015

Objectives : Clerodendron trichotomumThunberg grows wild fields and mountains in South Korea and China. They have been used for anti-hypertension disease. This study was performed in order to observe the effects ofClerodendron trichotomumThunberg tea on anti-hypertension.Methods : For the study ofClerodendron trichotomumThunberg tea, we had divided male SHR (Spontaneously Hypertensive Rat) to ten groups. Control group is SHR. The treatment group is SHR which is administered tea extract at dose of 200 mg/kg/day and 500 mg/kg/day orally for 8 weeks. We measured systolic blood pressure, diastolic blood pressure, number of pulse, body weight, total cholesterol and triglyceride from blood serum.Results : The level of systolic and diastolic blood pressure were significantly decreased by 12.5% and 44.9% inClerodendron trichotomumThunberg tea groups than control group. Heart rate ofClerodendron trichotomumThunberg tea groups, 24.5%, was significantly lower than control group. We found that treatment with the water extract fromClerodendron trichotomumThunberg leave and flower significantly decreased weight of body, total cholesterol and triglyceride to 20.4% and 27.7% compared to untreated control group, significantly (P< 0.05).Conclusions : These results suggest that leaf and flower tea ofClerodendron trichotomumThunberg tea is effective in prevention and treatment of hypertension and decreasing cholesterol. Long term consumption ofClerodendron trichotomumThunberg leaf and flower tea can be help in lowering high systolic and blood diastolic pressure, heart rate and blood serum in SHR.

• Korean Journal of Community Nutrition
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• v.5 no.4
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• pp.624-632
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• 2000

Nutrition related factors were investigated in one hundred and two hypertensive patients(Male : 44, female : 58) before they started drug treatment or diet therapy. The mean age of men and women were 49.9 and 53.5, respectively. Among the men, their mean SBP and DBP were 165.8 mmHg/108.4 mmHg. Fifty six point eight percent of men was classified as having in stage 3 hypertension(SBP $\geq$ 180 mmHg, or DBP $\geq$ 110 mmHg) and 45.5% was classified as having low renin hypertension (serum renin < 2.5 ng/ml/h). The proportion of overweight or obesity assessed by BMI($\geq$ 25) or body fat percent( $\geq$ 21%) was 47.7% or 80.9%, respectively. Men showed 19.1% of hypertriglyceridemia(serum TG $\geq$ 200 mg/dl), 42.6% of hypercholesterolemia(serum cholesterol $\geq$ 220 mg/dl), and 17.0% was observed as having serum cholesterol higher than 240 mg/dl. The proportion of men with high risk of cardiovascular disease was 72.3% assessed by atherogenic index( $\geq$3.4). The prevalence of drinking was 86.4% including a daily drinking proportion of 15.8%. Among women, their mean SBP and DBP were 162.6 mmHg/104.3 mmHg. Less women(43.1%) were classified as having stage 3 hypertension and more women were observed in low renin hypertension(55.1%). The prevalence of obesity or overweight assessed by BMI( $\geq$ 25) was 31.0% and 76.3% with body At percent($\geq$28%). Women revealed 24.1% of hypertriglyceridemia and 36.2% of hypercholesterolemia. The proportion of women who showed high risk of cardiovascular disease(atherogenic index $\geq$ 3.4) was 63.8%. The smoking rate was 8.6% and drinking rate was 43.1%.

• Journal of agricultural medicine and community health
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• v.19 no.2
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• pp.129-140
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• 1994

The survey has for its object to detect prevalence rate of hypertension in target population, to find out the risk factor to hypertension, to detect the hypertensive patients cared pattern and therefore, to consider a effective counter plan for the long term about hypertension. The study, population of this survey was 894 out of 1013 target population from Feb. 1 1994 to March 31 1994 in Kyougsang-namdo Ulsan-gun Samnam-myoun. For these two month, check of blood pressure and direct measurement of height and weight was carried out by mass screening and home visiting and had an interview about risk factors for hypertension and cared pattern by questionnaire. The results of survey were as follows : 1. The prevalence rate of 894 study, population was 27.5% and 26.0% in man and 28.6% in women. 2. In male, the prevalence rate for age group, family history of hypertension, drinking, salt intake by risk factors were significant statistically. 3. In female, the prevalence rate for salt intake, body mass index by risk factors were significant statistically. 4. Motivation which was diagnosed as hypertension was that be examined for subjective symptoms of hypertension and routine check for health was only 25.0%, 9.1% and visiting to the hospital for other diseases, detect hypertension by chance was 65.9%. 5. The experience of treatment in prevalent cases was significant statistically in middle class of SES. And the place of treatment by risk factors could not be significant statistically in spite of the majority selected hospital generally. 6. The reasons of non-compliance in prevalent cases was restricting daily activities for its 45.5% most high and the interruption of treatment in prevalent cases was far from hospital geographically for its 47.6% most high 7. The preventive behavior about hypertensive by risk factors or general characteristics wasn't significant statistically. 8. Being treated or not in the near future about age group, SES, family history of the hypertension was significant statistically. And with regard to the place of treatment in the near future, in spite of the majority selected hospital generally, it wasn't significant statistically. 9. The reasons of non-compliance in incidence cases was restricting daily activities for its 46.8% most high. 10. The preventive behavior in the near future about age group, education level, SES, family history of hypertension was significant statistically.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.2
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• pp.504-510
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• 2007

Kamicheonmagudeungeum(KCGE), a traditional herbal medicine, has been used as a therapeutic agent for the treatments of acute stage of hypertension. We evaluated the effects of KCGE on hypertension induced by DOCA-salt in rats. The systolic blood pressure and pulse rate significantly lowered by oral administration with KCGE. The levels of plasma hormones including dopamine, epinephrine and norepinephrine, and serum electrolyte were also reduced in KCGE treated rats. In addition, the production of reactive oxigen species (ROS) were greatly decreased by the treatment with KCGE in cultured bovine endothelial cells and angiotensine converting enzyme (ACE) activites were also inhibited by KCGE in a dose dependent manner. This study indicated that KCGE is a safe and effective treatment for hypertension.

• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.487-494
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• 2007

Objectives : Little is known about the physician-related factors that are associated with the management of Hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. Methods : We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do, Forty-one physicians completed the survey (response rates : 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the self-reported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center#s information system. We compared the physicians# perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians# antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physician-related factors. Results : The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients# control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensin-converting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI : 1.17-1.48). Conclusions : Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians# overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician# awareness regarding the management of patients with hypertension are needed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.4
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• pp.207-214
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• 2019

Objectives: Medically compromised patients often fear required dental surgical procedures that can increase the risk of medical emergency when combined with reduced tolerance for stress. A stress reduction protocol (SRP) helps doctors minimize treatment-related stress and improves patient management with minimum complications. Diabetes and co-morbid hypertension carry 4-fold risk of aggravation of cardiovascular emergencies and 7.2-fold risk of mortality. Diabetic neuropathy can result in difficult diagnosis of myocardial infarction and reduces chances of surviving a myocardial infarction compared with a non-diabetic person. The aim of the study was to assess the feasibility of a protocol for management of patients having both diabetes and hypertension who required minor oral surgery to minimize the rate of cardiovascular emergencies. Materials and Methods: A prospective study was conducted in 140 patients having both diabetes and hypertension who required minor oral surgical procedures. A systematic approachable protocol was designed for management of such patients. Results: Among 140 patients, 6 patients (4.3%) had cardiovascular complications, while 3 patients (1 with syncope and 2 with hypertension) did not require any intervention other than observation. Two patients were managed with aspirin and nitroglycerin, and 1 patient had possible myocardial infarction (overall incidence 0.7%) with chest pain, S-T segment elevation on electrocardiogram, and troponin level of 0.60 ng/mL. Conclusion: The proposed protocol helps to improve management of patients having both diabetes and hypertension. We recommend that patients with uncontrolled diabetes and uncontrolled hypertension and/or patients having history of cardiovascular complication should be treated in a medical facility with a readily available cardiology unit. This facilitates prompt response to emergency and instant implementation of treatment, helping to reduce morbidity and mortality.

• Journal of Korean Public Health Nursing
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• v.33 no.2
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• pp.228-241
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• 2019

Purpose: The purpose of this study was to evaluate the prevalence, awareness, treatment and control of hypertension, diabetes, and dyslipidemia among women with rheumatoid arthritis. Methods: This cross-sectional study of 288 women with rheumatoid arthritis was conducted in a university-affiliated hospital. Data were collected by reviewing the women's medical charts and self-report questionnaires. Results: The prevalence of hypertension, diabetes and dyslipidemia was 27.8%, 5.9% and 48.3%, respectively. Despite the high prevalence of dyslipidemia, the subjects'awareness of it and its treatment rates were the lowest, which resulted in a low control rate. Of the 288 subjects, 158 (55%) had at least one of the three conditions. The prevalence of the combination of cardiovascular risk factors increased with age, and 32.7% of those aged 60 or older had two or three of the cardiovascular risk factors. Combinations of cardiovascular risk factors were significantly related with severe pain and fatigue. Conclusion: Cardiovascular risk factors were highly prevalent among the women with rheumatoid arthritis, but the rates of awareness, treatment, and control were suboptimal. There is a pressing need to facilitate the prevention, early detection and appropriate management of hypertension, diabetes and dyslipidemia among patients with rheumatoid arthritis in order to prevent cardiovascular disease.