scholarly journals Psychosocial approach: quality of life in young people with elevated blood pressure

2011 ◽  
Vol 10 (2) ◽  
pp. 18-23
Author(s):  
D. I. Sadykova ◽  
I. Ya. Lutfullin
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Psychological Functioning ◽  
Blood Pressure Monitoring ◽  
White Coat ◽  
Clinical Psychologist ◽  
White Coat Hypertension ◽  
Physical Dysfunction ◽  
Essential Arterial Hypertension

Aim. To study quality of life (QoL), as an instrument for standardized assessment and monitoring of patients’ psychosocial status. Psychosocial approach is particularly important in diseases with psychosomatic component, such as essential arterial hypertension (EAH). Material and methods. QoL was assessed in 101 adolescents (62 boys, 39 girls; age 14-17 years) with various EAH forms, as well as in 38 healthy adolescents (comparison group, CG). Based on the results of 24-hour blood pressure monitoring (BPM), all patients were divided into 3 groups: with white-coat hypertension (n=32); with labile AH (n=33); and with stable AH (n=36). QoL was assessed with the MOS SF-36 scale, measuring not only absolute QoL values, but also the “proxy-problem” phenomenon (the discrepancy between QoL reported by the patients themselves and their proxies – parents). Results. Compared to the CG, adolescents with various BP levels demonstrated reduced QoL. QoL reduction was minimal in adolescents with white-coat hypertension, and maximal in patients with labile AH. In the latter group, both physical and psychological functioning parameters were reduced. The parents of EAH adolescents typically overestimated the severity of physical dysfunction of their children, while underestimating the magnitude of psychological dysfunction. Conclusion. The results obtained confirm the important role of psychosomatic mechanisms in AH pathogenesis, and emphasize the need for psychiatrist or clinical psychologist’ participation in the treatment of hypertensive adolescents. In adolescents with stable AH, physical dysfunction was predominant.

Abstract P634: The Influence Of Virtual Learning Environment On Therapy Adherence And On The White Coat Effect

Hypertension ◽  
2015 ◽  
Vol 66 (suppl_1) ◽  
Author(s):  
Isabela R Fistarol ◽  
Chao L Wen ◽  
Luiz Bortolotto ◽  
Margarida Vieira ◽  
Miriam Tsunemi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Educational Technology ◽  
Learning Environment ◽  
Statistical Difference ◽  
Virtual Learning Environment ◽  
White Coat ◽  
Study Group ◽  
White Coat Effect

Systemic arterial hypertension is a risk factor for cardiovascular diseases and has become a common public health problem. Health education associated with educational technology may be used to encourage patients’ adherence to treatment and enable them to adequately understand how harmful hypertension can be to health, thereby promoting their quality of life. OBJECTIVE: To evaluate the influence of a strategy in an individual orientation program using educational technology associated with virtual learning environment (VLE) of hypertension care on the reduction in the white coat effect and the improvement in blood pressure control to be promoted by a nurse in a hypertension unit in a government state hospital in São Paulo. METHODS AND MATERIALS:This was a randomized clinical education study conducted with two groups, the VLE group (study group, 10 patients) and the control group (16 patients). Both groups were interviewed 6 times by nurses during the 120-day follow-up at 20-day intervals. At baseline (randomization) and at the end of the study, the patients took Spielberg’s State-Trait Anxiety Inventory (STAI), the Morisky test, and the WHOQOL, a quality of life instrument, and had their blood pressure taken (ambulatory blood pressure monitoring [ABPM]). Both groups had their blood pressure, weight, and abdominal circumference measured. Only the study group had remote access to the VLE. This consisted of 6 specific educational modules, each released according to the encounter number. RESULTS: At baseline, there were no statistical differences between the two groups with respect to the sociodemographic and hemodynamic variables. At the end of the study, there was a significant statistical difference between the groups on the Morisky test (p=0.001) and on the WHOQOL with respect to domain 3 social (p=0.001). There was no statistical difference with respect to the white coat effect between the groups. Nor was there any statistical difference between the groups with respect to the association of the anxiety degree measured by STAI and the white coat effect.CONCLUSION: In light of the results, our strategy improved the quality of life in the social domain and changed the adherence behavior of the study group in relation to the forgetfulness of medication schedules.

scholarly journals Hypertension Subtypes among Thai Hypertensives: An Analysis of Telehealth-Assisted Instrument in Home Blood Pressure Monitoring Nationwide Pilot Project

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Sakolwat Montrivade ◽  
Pairoj Chattranukulchai ◽  
Sarawut Siwamogsatham ◽  
Yongkasem Vorasettakarnkij ◽  
Witthawat Naeowong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Demographic Data ◽  
Real Life ◽  
Antihypertensive Agents ◽  
Home Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Routine Practice ◽  
White Coat Effect

Background. White-coat hypertension (HT), masked HT, HT with white-coat effect, and masked uncontrolled HT are well-recognized problems of over- and undertreatment of high blood pressure in real-life practice. However, little is known about the true prevalence in Thailand. Objectives. To examine the prevalence and characteristics of each HT subtype defined by mean home blood pressure (HBP) and clinic blood pressure (CBP) using telemonitoring technology in Thai hypertensives. Methods. A multicenter, observational study included adult hypertensives who had been diagnosed for at least 3 months based on CBP without the adoption of HBP monitoring. All patients were instructed to manually measure their HBP twice a day for the duration of at least one week using the same validated automated, oscillometric telemonitoring devices (Uright model TD-3128, TaiDoc Corporation, Taiwan). The HBP, CBP, and baseline demographic data were recorded on the web-based system. HT subtypes were classified according to the treatment status, CBP (≥or <140/90 mmHg), and mean HBP (≥or <135/85 mmHg) into the following eight subtypes: in nonmedicated hypertensives, there are four subtypes that are normotension, white-coat HT, masked HT, and sustained HT; in treated hypertensives, there are four subtypes that are well-controlled HT, HT with white-coat effect, masked uncontrolled HT, and sustained HT. Results. Of the 1,184 patients (mean age 58 ± 12.7 years, 59% women) from 46 hospitals, 1,040 (87.8%) were taking antihypertensive agents. The majority of them were enrolled from primary care hospitals (81%). In the nonmedicated group, the prevalence of white-coat and masked HT was 25.7% and 7.0%, respectively. Among the treated patients, the HT with white-coat effect was found in 23.3% while 46.7% had uncontrolled HBP (a combination of the masked uncontrolled HT (9.6%) and sustained HT (37.1%)). In the medicated older subgroup (n = 487), uncontrolled HBP was more prevalent in male than in female (53.6% vs. 42.4%, p=0.013). Conclusions. This is the first nationwide study in Thailand to examine the prevalence of HT subtypes. Almost one-fourth had white-coat HT or HT with white-coat effect. Approximately half of the treated patients especially in the older males had uncontrolled HBP requiring more intensive interventions. These results emphasize the role of HBP monitoring for appropriate HT diagnosis and management. The cost-effectiveness of utilizing THAI HBPM in routine practice needs to be examined in the future study.

scholarly journals Patient Barriers and Facilitators to Ambulatory and Home Blood Pressure Monitoring: A Qualitative Study

2018 ◽  
Vol 31 (8) ◽  
pp. 919-927 ◽  
Author(s):  
Eileen J Carter ◽  
Nathalie Moise ◽  
Carmela Alcántara ◽  
Alexandra M Sullivan ◽  
Ian M Kronish
Keyword(s):  
Blood Pressure ◽  
New York ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
Barriers And Facilitators ◽  
White Coat ◽  
White Coat Hypertension ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Monitoring Method

Abstract BACKGROUND Guidelines recommend that patients with newly elevated office blood pressure undergo ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM) to rule-out white coat hypertension before being diagnosed with hypertension. We explored patients’ perspectives of the barriers and facilitators to undergoing ABPM or HBPM. METHODS Focus groups were conducted with twenty English- and Spanish-speaking individuals from underserved communities in New York City. Two researchers analyzed transcripts using a conventional content analysis to identify barriers and facilitators to participation in ABPM and HBPM. RESULTS Participants described favorable attitudes toward testing including readily understanding white coat hypertension, agreeing with the rationale for out-of-office testing, and believing that testing would benefit patients. Regarding ABPM, participants expressed concerns over the representativeness of the day the test was performed and the intrusiveness of the frequent readings. Regarding HBPM, participants expressed concerns over the validity of the monitoring method and the reliability of home blood pressure devices. For both tests, participants noted that out-of-pocket costs may deter patient participation and felt that patients would require detailed information about the test itself before deciding to participate. Participants overwhelmingly believed that out-of-office testing benefits outweighed testing barriers, were confident that they could successfully complete either testing if recommended by their provider, and described the rationale for their testing preference. CONCLUSIONS Participants identified dominant barriers and facilitators to ABPM and HBPM testing, articulated testing preferences, and believed that they could successfully complete out-of-office testing if recommended by their provider.

scholarly journals White coat hypertension: current state of the issue

2021 ◽  
Vol 28 (2) ◽  
pp. 71-78
Author(s):  
K. H. Uvarova
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Treatment ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Prognostic Significance ◽  
Home Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Lifestyle Modifications ◽  
Cardiovascular Morbidity And Mortality

More than 30 years have passed since the first description of such a concept as white coat hypertension was presented in the scientific literature, but since then, scientists are paying more and more attention to this condition. White coat hypertension is defined when the blood pressure readings obtained in the doctor’s office meet the criteria for hypertension, but the latter is not confirmed by outpatient or home blood pressure monitoring. Initially, the term was only applied to patients who had not received antihypertensive treatment, but recently this definition has been extended to people who regularly take drugs for lowering blood pressure, and this condition was called uncontrolled white coat hypertension. Some of the world’s most influential organizations in the field of cardiology have not reached a consensus on the definition of white coat hypertension on the background of common criteria, which has affected the differences in blood pressure thresholds according to outpatient monitoring. Quite a few studies in recent years have examined the clinical and prognostic significance of white coat hypertension in terms of its probable effects such as metabolic disorders, subclinical and extracardiac target organ damage, cardiovascular morbidity and mortality, and all-cause mortality. At present, there is no doubt that white coat hypertension is not an innocent condition; however, hypotheses about the prognostic role of this condition and the management of patients with white coat hypertension are still controversial. The question of treating white coat hypertension as a condition remains unsolved and requires further investigation. Today, it is considered most appropriate not to prescribe antihypertensive treatment to persons with office blood pressure at normal or below target levels, but to intensify lifestyle modifications and focus on reduction of cardiovascular risk.

scholarly journals Comparison of ambulatory blood pressure monitoring and self-blood pressure monitoring for diagnosing white coat hypertension amongst pregnant women

2019 ◽  
Vol 9 (1) ◽  
pp. 274
Author(s):  
Sandeep Sood ◽  
Sirisha Anne ◽  
Kuldeep Kumar Ashta ◽  
Ravi Kumar
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Gestational Hypertension ◽  
Blood Pressure Monitoring ◽  
Antenatal Clinic ◽  
White Coat ◽  
White Coat Hypertension ◽  
Pressure Monitoring

Background: White coat hypertension (WCH) is a common and well recognized phenomenon. It is also very prevalent amongst pregnant women and is often diagnosed as chronic/ gestational hypertension leading to unnecessary medications during pregnancy. ABPM is the gold standard for diagnosis of WCH. SBPM is an easy effective and reliable method to measure blood pressure but its efficacy needs to be tested and compared with ABPM in cases of WCH. It is important to compare the two methods in assessing WCH so SBPM can be utilized in cases of WCH, if found useful and efficacious.Methods: All pregnant women who presented to the ANC were screened for hypertension. Those who were diagnosed to be hypertensive in antenatal clinic and these patients were then admitted for ambulatory blood pressure monitoring (ABPM) for 24 hours and SBPM on 6 hourly bases for 5 days.Results: The ABPM and SBPB readings were noted, tabulated and compared. It was found that the prevalence of ‘WCH’ in this study using ABPM and SBPM were 47.368% (27/54) and 45.614% (26/54) respectively.Conclusions: The results in diagnosing WCH using ABPM and SBPM were comparable.

A STUDY ON THE PREVALENCE OF DIPPER AND NON-DIPPER BLOOD PRESSURE BY USING 24 HOUR AMBULATORY BLOOD PRESSURE MONITORING (ABPM) IN HUE UNIVERSITY HOSPITAL

2011 ◽  
pp. 60-64
Author(s):  
Van Tam Le ◽  
Van Minh Huynh
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Left Ventricular ◽  
University Hospital ◽  
White Coat ◽  
White Coat Hypertension ◽  
Pressure Monitoring ◽  
Hypertensive Group

Objectives: To determine the prevalence of dipper and non-dipper blood pressure by using 24 hour ambulatory blood pressure monitoring (ABPM) and to assess the correlation between target organ damage with white coat hypertension and real hypertension. Patients and method: Data from 60 hypertensives including 38 males and 22 females, ages from 25 to 75 yrs were analysed. The 24h ABPM made by German Tonoport’s were used for the measurement of blood pressure with the program 30 minutes per time and ECG and Echocardiography were used to assess the changes in left ventricular structure. Results: - White coat hypertensive group: The prevalence of dipper blood pressure was 43,75% and non-dipper was 56,25%.- real hypertensive group: The prevalence of dipper was 38,64% and non-dipper was 61,36%. There hadn’t the left ventricular hypertropy and lession of ocular fundus in patients who had white coat hypertension. Conclusions: By using the 24 hour ambulatory blood pressure monitoring (ABPM) we can detect the dipper and non-dipper phenomenon of blood pressure

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