• 제목/요약/키워드: treatment rate of hypertension

검색결과 205건 처리시간 0.024초

악성고혈압의 바이오피드백 단기 혈압강하 치험1례 (The short-term effect of Blood Pressure Reduction after Biofeedback in Malignant Hypertension: A case report)

  • 오승윤; 김연주; 김락형; 박수정
    • 대한한의학회지
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    • 제45권1호
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    • pp.251-256
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    • 2024
  • Objectives: The purpose of this study was to report the short-term blood pressure-lowering effects observed in a patient with malignant hypertension through slow breathing maneuver with heart rate variability(HRV) biofeedback. Methods: Biofeedback sessions, totaling 13, each lasting 10 minutes, were administered. Blood pressure was measured pre and post-treatment, as well as thrice daily at 10 am, 4 pm, and 8 pm. Systolic blood pressure(SBP), diastolic blood pressure(DBP), and pulse rate were recorded for comparative analysis. Results: Before biofeedback, the average SBP, DBP, and pulse rate were 227.2±18.3, 135.2±11.0, and 104.4±5.3, respectively. Immediately post-biofeedback, these values changed to 213.7±15.2, 126.9±8.5, and 99.2±3.6. However, sustained long-term blood pressure reduction was not observed. Conclusions: The findings suggest that biofeedback therapy induces a short-term reduction in blood pressure in cases of malignant hypertension, potentially associated with autonomic nervous system regulation. Integrating biofeedback with other Korean medicine treatments, such as acupuncture or moxibustion, may offer a comprehensive approach for managing malignant hypertension.

간양상항방(肝陽上亢方)이 고혈압(高血壓)에 미치는 영향 (Effect of Ganyangsanghang-bang on Hypertension)

  • 한덕희;오영선;설인찬;김윤식
    • 동의생리병리학회지
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    • 제20권3호
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    • pp.663-669
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    • 2006
  • This study was done to investigate the effect of Ganyangsanghang-bang(GYSHB) on hypertension. After administering GYSHB extract to SHR for 5 weeks, changes in blood pressure, pulse rate, aldosterone and catecholamine levels in plasma were examined, and immunohistochemical changes were observed, and liver function test was done. The following results were obtained; blood presure decreased significantly as well as levels of aldosterone and norepinephrine in SHR. But levels of dopamine were unaffected. No capillary vessel dilation in adrenal cortex was observed. Safety against hepatic toxicity was showed. These results support a role for GYSHB might be usefully applied in treatment of hypertension.

가미사물탕(加味四物湯)이 고혈압에 미치는 영향 (Effect of Gamisamool-tang(GMSMT) on Hypertension)

  • 조봉현;김윤식;설인찬
    • 동의생리병리학회지
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    • 제20권1호
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    • pp.131-137
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    • 2006
  • This study was done to investigate the effect of Gamisamool-tang(GMSMT) on hypertension. After administering GMSMT extract to SHR for 5 weeks, changes in blood pressure, pulse rate, aldosterone and catecholamine levels in plasma were examined, and immunohistochemical changes were observed, and liver function test was done. The following results were obtained; blood presure decreased significantly as well as levels of aldosterone, norepinephrine and epinephrine in SHR, But levels of dopamine were unaffected. No capillary vessel dilation in adrenal cortex was observed. Safety against hepatic toxicity was showed. These results support a role for GMSMT might be usefully applied in treatment of hypertension.

가미계혈등탕(加味鷄血藤湯)이 고혈압(高血壓)에 미치는 영향(影響) (The Effect of Gamigehyuldeung-tang on Hypertension)

  • 오영선;김윤식;설인찬;유병찬
    • 대한한방내과학회지
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    • 제25권4호
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    • pp.52-64
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    • 2004
  • Objectives : This study was done to investigate the effect of Gamigehyuldeung-tang on hypertension. Methods : After administering Gamigehyuldeung-tang extract to SHR(Spontaneous Hypertensive Rats) for 5 weeks, changes in blood pressure, pulse rate, aldosterone and catecholamine levels in plasma were examined, and immunohistochemical changes and scanning electron microscopic changes were observed. Results : The following results were obtained; blood presure decreased significantly as well as levels of aldosterone, dopamine and epinephrine in SHR. But levels of norepinephrine were unaffected. No capillary vessel dilation was observed. A decrease in cell damage was seen in microscope investigation. Conclusions : These results support a role for Gamigehyuldeung-tang might be usefully applied in treatment of hypertension.

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공중보건의의 고혈압 진단 및 치료과정 평가 (Quality Evaluation for the Diagnosis and Management of Hypertensives by Pubilc Health Doctors)

  • 송윤미;김윤;조홍준;정희숙;김용익
    • 한국의료질향상학회지
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    • 제3권1호
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    • pp.126-143
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    • 1996
  • Background : Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them. Methods : Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension. Results : Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.9%). Level of training, duration of practice ad a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05). Conclusion : These public health doctors showed poor compliance with the pre-established clinical guidelines, which leaves much to be desired in diagnosing and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.

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민관협력을 통한 고혈압.당뇨병 등록.관리사업의 접근 전략: 홍천군 사례의 정책적 함의 (Accessible Strategy of the Registration & Management of Hypertension and Diabetes Mellitus Patients through the Public-Private Partnership: Policy Implications Fron the Hongcheon-gun Case)

  • 변도화;김은정;박명배;손효림;박혜경;김춘배
    • 보건교육건강증진학회지
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    • 제30권4호
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    • pp.111-123
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    • 2013
  • Objectives: This study aimed to share with experiences of a demonstration program based on a community for prevention and management of hypertension and diabetes mellitus, and to supply the evidence of accessible strategies within the community through the public-private partnershipin the near future. Methods: This study case was "the program of registration and management of hypertension and diabetes mellitus patients" which was conducted in Hogncheon-gun in Gangwon-province, 2012. Results: The infrastructure of this center was constructed with the public-private sector partnership according to the basic model of demonstration program since November, 2012. So, the total registered rate of hypertension and diabetes mellitus patients were 26.6% in comparison with suspected patients (to the result of 2011 Korea National Health and Nutrition Examination Survey), 37.8% in comparison with the real number of outpatient (to the claims data of 2011 Branch Honcheon-gun, National Health Insurance Corporation), and 107.8% in comparison with the project goal, sequentially. To the patients who were not treated for 30 and 60 days among the registered patients, a recall service was conducted. Through this intervention, it was monitored that this program has enhanced the consecutive treatment rate of the registered patients. Conclusions: To improve the continuous management of hypertension and diabetes mellitus patients, we are gotten to know that the community need the joint participation and mutual cooperation with public-private sector partnership.

우리나라 만성질환 관리를 위한 질환주치의 모형의 타당성 분석 (A National Chronic Disease Management Model and Evaluation of Validity of Primary Care Physician(PCP) Model in Korea)

  • 전기홍;백경원;이수진;박종연
    • 보건행정학회지
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    • 제19권3호
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    • pp.92-108
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    • 2009
  • This study suggests a model for continuing and comprehensive management of hypertension or Type 2 diabetes mellitus (T2DM) in Korea. Moreover, this paper computed the contribution cost of hypertension or T2DM management using the healthcare medical cost, which could have occurred from stroke, myocardial infarction (MI), and end-stage renal disease (ESRD) that were successfully prevented from the effective hypertension or T2DM management. Additionally, these costs were compared with the cost of implementing the hypertension or T2DM management model suggested in this study. This study used the medical fee summary of the health insurance claims submitted to National Health Insurance Corporation by medical facilities for services provided during the period from January 1st 1999 to December 31st 2006. The prevalence rate with treatment referred to cases in which patients submitted their medical claims at least once during the period, along with an accordant diagnosis. The incidence rate with treatment referred to cases in which patients who never submitted claims for the accordant disease during the five years from 1999 to 2003 submitted claims for the accordant disease in 2004 and 2005. The relative risk of the occurrence of stroke, MI and ESRD was 11.0, 13.6, and 30.3, respectively. The attributable risk of hypertension or T2DM for stroke was 0.730, and that for MI and ESRD were 0.773 and 0.888, respectively. Based on these, the contribution cost of hypertension or T2DM is estimated to be 986.3 billion Korean Won(KRW) for stroke patients, 330.5 billion KRW for MI patients, and 561.7 billion KRW for ESRD patients as in 2005. Hence, the total contribution cost of hypertension or T2DM to stroke, MI, and ESRD is 1.878 trillion KRW. The estimate for operational costs included an annual expenditure of 50,000 KRW per each recipient and an annual subsidy of 0.22 million KRW per person for the 1.6 million low.income individuals with hypertension or T2DM to cover their out.of.pocket medical expenses. Under this assumption, it took approximately 0.6 trillion KRW to manage 5 million high.risk patients in the low. and mid.income range, coverings up to 50% of costs. In conclusion, considering the potential benefits of preventing stroke, MI, and ESRD, the costs seems to be reasonable.

일 지역 성인의 고혈압 유병률 및 관리 실태 (A Study on the Prevalence Rate of Hypertension and the Actual Conditions of Control)

  • 김현옥
    • 지역사회간호학회지
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    • 제10권1호
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    • pp.154-172
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    • 1999
  • In order to analyse the prevalence rate of hypertension and the actual conditions of control, we selected five districts out of eleven eups and myuns in Chinan Country. We administered structured questionaries to 309 adults above the age of 40, computerized the data using SPSS - PC+. More than 40.1% of adults over 40 in Chinan County have health disorders ranging from high blood pressure to hypertension including alert high blood pressure at 36.2%, relatively high. Among general characteristics, differences in the rate of hypertension were influenced by age, occupation and places of residence. Over 71 who are engaged in agriculture, who don't have jobs, who reside in Sungsu, Jungchun, Chinan-eup all have higher hypertension rates than other groups. Accordingly, the control of hypertension should be focused on these people. As a result of the control of blood pressure, the survey showed 93.0% of the subjects were checked mainly at hospitals clinics, health centers subhealth centers and community health posts more than once a year, relatively high level of blood pressure management. However, the difference between their blood pressure measurements at ordinary times and the level of blood pressure at the time of research was quite considerable. Only 47.3% of the subjects diagnosed with high blood pressure and 70.3% of the subjects with normal blood pressure recognized their blood pressure accurately 52.7% of the subjects diagnosed with high blood pressure showed errors in understanding their blood pressure at normal times. Because these errors can cause problems in the control of blood pressure, proper management should be executed through a systematic examination. As a result of the high blood pressure control condition, the average period of hypertension was 74.5( ${\pm}92.8$) months, 92.3% of the subjects were diagnosed with high blood pressure at hospitals clinics, health centers subhealth centers community health posts, but only 29.5% were examined after a general check up on high blood pressure was completed. 70.5% were diagnosed with high blood pressure only after measuring their blood pressure. 14.1% of the subjects were hospitalized because of falls influenced by high blood pressure. 33.3% attended hospitals and health centers regularily for medical treatment and this shows how low the rate of the control of blood pressure. Most people did not undergo medical treatment, because they had no painful symptoms (46.7%), they didn't need to take the medicine(28.9%), or they forget to take the medicine(20.0%). These problems in the control of hypertension were discovered in the process of diagnosing high blood pressure at health medical institutions. Many people did not recognize the need for consistent control of blood pressure. That is, although the diagnosis for high blood pressures performed at hospitals clinics, health centers subhealth centers and community health posts, was 92.3%, more than 70.5% of the subjects were not examined completely with regard to blood pressure. Accordingly, heath medical institutions must diagnose high blood pressure not only by only measuring blood pressure but also by using systematic process of examination. As for the people diagnosed with high blood pressure, one should perform consistent medical approaches and help them to recognize the importance of the continuous control of blood pressure through subject-oriented education. Problems the subjects experienced were the following numbness in the limbs easily paralyzed stitches in their shoulders which felt painful, stiff necks, occiputs felt heavy, headaches when they got up in the morning, felt dizzy when standing and moving their heads and poor eyesight. The rate of knowledge related to high blood pressure was 78.7 points, comparatively low. Whether they had normal blood pressure or hypertension made no difference. These results are not desirable. Adult-oriented education forgot the prevention and management of high blood pressure should be implemented. Hypertensive-oriented education should be especially reinforced. Because there was a difference in the level of knowledge according to age, academic career, occupation or place of residence, education related to hypertension should be intensified and focused on those over the age of 71 those who did not attend school, those who do not have jobs and are engaged in agriculture and residents living in Bugui, Jungchun regions. The degree of healthy life practice in hypertensives is poor, particularly weight control, as opposed to people who have normal blood pressure. It makes no difference in smoking, the amount of daily smoking, drinking, the control of salt because each result means that they are not practicing healthy life or modifying their life-style. The development and programs to improve a healthy life should be executed.

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고혈압을 동반하는 중고도 비만 환자의 중의학 임상연구 체계적 고찰: CNKI 검색을 중심으로 (Systematic Review of TCM on Moderate to Severe Obese Patients with Hypertension in Chinese Medical Journal (CNKI))

  • 박소현;김준호
    • 한방비만학회지
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    • 제23권2호
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    • pp.86-97
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    • 2023
  • Objectives: The purpose of this study is to review clinical studies related to the effect of Traditional Chinese Medicine (TCM) on moderate to severe obese patients with hypertension. Methods: Clinical studies from the China National Knowledge Infrastructure (CNKI) were searched by specific keywords and criteria. Total of 7 randomized controlled trials were selected and analyzed. Results: Various evaluation methods were used to see the effect of TCM compared to conventional western medicine. Most of the studies used herbal medicine combined with conventional anti-hypertensive western medicine. The effective rate of anti-hypertension was higher when TCM was added to conventional anti-hypertensive medicine. Traditional medicine treatment showed significant effect on lowering blood pressure and body mass index. Conclusions: Based on the results of the clinical studies from China, TCM can be a valuable option for moderate to severe obese patients with hypertension. Applying Traditional medicine has a significant effect on lowering blood pressure and weight loss. Combining herbal medicine can be worthy of clinical promotion and application for moderate and severe obese patients with hypertension.

Effects of the Out-of-pocket Payment Exemption in the Public Health Center on Medical Utilization of the Korean Elderly

  • Nam, Kiryong;Park, Eunhye;Chung, Yuhjin;Kim, Chang-yup
    • Journal of Preventive Medicine and Public Health
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    • 제53권6호
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    • pp.455-464
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    • 2020
  • Objectives: The distribution of hospitals in Korea is unbalanced in terms of accessibility. Many local public health centers (PHCs) exempt out-of-pocket payments (OOPs) based on local government laws to increase coverage. However, this varies across administrative regions, as many make this exemption for the elderly, while others do not. This study aimed to evaluate the effects of the OOP exemption at local PHCs among elderly individuals. Methods: This study used online data on Korean national law to gather information on individual local governments' regulations regarding OOP exemptions. Individual-level data were gathered from the 2018 Community Health Survey and regional-level data from public online sources. Results: The study analyzed 132 regions and 44 918 elderly people. A statistical analysis of rate differences and 2-level multiple logistic regression were carried out. The rate difference according to whether elderly individuals resided in areas with the OOP exemption was 1.97%p (95% confidence interval [CI], 1.07 to 2.88) for PHC utilization, 1.37%p (95% CI, 0.67 to 2.08) for hypertension treatment, and 2.19%p (95% CI, 0.63 to 3.74) for diabetes treatment. The regression analysis showed that OOP exemption had an effect on hypertension treatment, with a fixed-effect odds ratio of 1.25 (95% CI, 1.05 to 1.48). Conclusions: The OOP exemption at PHCs can affect medical utilization in Korea, especially for hypertension treatment. The OOP exemption should be expanded to improve healthcare utilization in Korea.