scholarly journals Uncontrolled hypertension prevalence, treatment and blood pressure levels: An analysis of New Zealand primary care data

2015 ◽  
Vol 24 ◽  
pp. S83-S84
Author(s):  
Y. Gu ◽  
N. Walker ◽  
G. Humphrey ◽  
J. Warren ◽  
J. Kennelly ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
New Zealand ◽  
Uncontrolled Hypertension ◽  
Hypertension Prevalence ◽  
Primary Care Data

scholarly journals Primary care doctors’ views on self-monitoring of blood pressure and self-titration among patients with uncontrolled hypertension in Spain. The ADAMPA trial focus group study.

BJGP Open ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. bjgpopen20X101062
Author(s):  
Irene Marco-Moreno ◽  
Patricia Martínez-Ibañez ◽  
Eugenia Avelino-Hidalgo ◽  
Laura Bellot-Pujalte ◽  
Ignacio Barreira-Franch ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Focus Group ◽  
Home Monitoring ◽  
Self Management ◽  
Uncontrolled Hypertension ◽  
Focus Group Study ◽  
Self Monitoring ◽  
Primary Care Doctors ◽  
Role Of Nursing

BackgroundDespite the increased use of blood pressure (BP) monitoring devices at home, the hypertension of more than 50% of European patients remains uncontrolled. Nevertheless, the self-management of BP, through the combination of home monitoring of BP with self-titration, could be anaccessible and effective tool for improving hypertension control in the primary care setting. The ADAMPA study is a trial with participants randomised to BP self-management (BPSM) with self-titration of antihypertensive medication or to usual care, in a population of patients with poorly controlled hypertension.AimTo explore the views and attitudes of primary care doctors participating in the ADAMPA trial regarding BPSM with self-titration.Design & settingA focus group study took place with primary care doctors participating in the ADAMPA trial, which was carried out in one health district of the Valencia Health System in Spain.MethodNine primary care doctors participating in the ADAMPA trial were included in the focus group. Three researchers (two using manual methods and one using NVivo software) independently conducted a content analysis, reading the transcripts, identifying, classifying, and coding the contents, and developing a conceptual scheme based on these topics.ResultsParticipating doctors clearly support home BP monitoring (HBPM), the setting of individual BP targets, and incorporating patient readings into decision-making. They consider it an investment to educate patients for medication self-adjustment and estimate that an important proportion of their patients are potential candidates for hypertension self-management with medication self-titration. However, they show important divergences regarding the role of nursing in BP control.ConclusionPrimary care doctors participating in the ADAMPA trial feel comfortable with BPSM with self-titration, and would consider extending its use (or the use of some components, such as BP target setting) to other patients with hypertension outside the trial.

scholarly journals Control of blood pressure and cardiovascular risk in Moroccan patients with newly diagnosed hypertension: a 3-month observational study in primary care

2016 ◽  
Vol 11 (2) ◽  
pp. 49-56 ◽  
Author(s):  
Mohamed Alami ◽  
Mustapha El Hattaoui ◽  
Mehdi Seqat ◽  
Jamaa Sadik ◽  
Aicha Aouad ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Uncontrolled Hypertension ◽  
Newly Diagnosed ◽  
High Cardiovascular Risk ◽  
Prospective Longitudinal Study ◽  
Hypertensive Patients ◽  
Prospective Longitudinal

Background: Control of blood pressure and reduction of cardiovascular risk factors are mandatory in patients with hypertension. The aim of this study was to determine the proportion of patients with controlled hypertension and to describe the cardiovascular risk profile in hypertensive patients followed by general practitioners (GPs) in Morocco. Methods: This national, observational, multicentre, prospective, longitudinal study of patients with newly diagnosed hypertension was carried out between September 2011 and December 2011. The use of antihypertensive drugs was evaluated at inclusion and after 3 months of follow up. Uncontrolled hypertension was defined as systolic blood pressure (SBP) ⩾ 140 mmHg or diastolic blood pressure (DBP) ⩾ 90 mmHg at 3 months of follow up. The SCORE scale issued by the European Society of Cardiology (ESC) was used to assess overall cardiovascular risk and probability of experiencing a cardiovascular event within 10 years. Results: A total of 909 hypertensive patients were recruited (62.4% female). Mean age was 56.8 ± 10.6 years. More than half of the patients (53.0%) were between 40–60 years and more than one-third (34.1%) were obese [body mass index (BMI) ⩾ 30 kg/m2]. There were significantly more obese females than males ( p < 0.001). Over half of the patients (52.5%) had a high or extremely high cardiovascular risk. Abdominal obesity (measured as waist circumference) was the most common cardiovascular risk factor (61.7%) followed by age (40.5%), dyslipidaemia (36.3%) and diabetes (34.3%). Mean SBP decreased from 168.1 ± 14.8 to 138.3 ± 13.2 mmHg ( p < 0.001) and mean DBP decreased from 93.0 ± 10.5 to 81.0 ± 8.6 mmHg ( p < 0.001) after 3 months of treatment. Control of blood pressure was achieved in only 46.8% of patients. Poor compliance (17.1%) and a lack of treatment efficacy (16.9%) were the two main reasons for not achieving the blood pressure target. Conclusions: More than half (53.2%) of the hypertensive patients in our study did not achieve adequate blood pressure control during the 3-month follow-up period and had a high cardiovascular risk. More effective management of hypertension is required in primary care.

scholarly journals Are self-reported telemonitored blood pressure readings affected by end-digit preference: a prospective cohort study in Scotland

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019431 ◽  
Author(s):  
Richard A Parker ◽  
Mary Paterson ◽  
Paul Padfield ◽  
Hilary Pinnock ◽  
Janet Hanley ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Automatic Transmission ◽  
Transmission System ◽  
Text Messages ◽  
Uncontrolled Hypertension ◽  
Digit Preference

ObjectiveSimple forms of blood pressure (BP) telemonitoring require patients to text readings to central servers creating an opportunity for both entry error and manipulation. We wished to determine if there was an apparent preference for particular end digits and entries which were just below target BPs which might suggest evidence of data manipulation.DesignProspective cohort studySetting37 socioeconomically diverse primary care practices from South East Scotland.ParticipantsPatients were recruited with hypertension to a telemonitoring service in which patients submitted home BP readings by manually transcribing the measurements into text messages for transmission (‘patient-texted system’). These readings were compared with those from primary care patients with uncontrolled hypertension using a system in which readings were automatically transmitted, eliminating the possibility of manipulation of values (‘automatic-transmission system’).MethodsA generalised estimating equations method was used to compare BP readings between the patient-texted and automatic-transmission systems, while taking into account clustering of readings within patients.ResultsA total of 44 150 BP readings were analysed on 1068 patients using the patient-texted system compared with 20 705 readings on 199 patients using the automatic-transmission system. Compared with the automatic-transmission data, the patient-texted data showed a significantly higher proportion of occurrences of both systolic and diastolic BP having a zero end digit (OR 2.1, 95% CI 1.7 to 2.6) although incidence was <2% of readings. Similarly, there was a preference for systolic 134 and diastolic 84 (the threshold for alerts was 135/85) (134 systolic BP OR 1.5, 95% CI 1.3 to 1.8; 84 diastolic BP OR 1.5, 95% CI 1.3 to 1.9).ConclusionEnd-digit preference for zero numbers and specific-value preference for readings just below the alert threshold exist among patients in self-reporting their BP using telemonitoring. However, the proportion of readings affected is small and unlikely to be clinically important.Trial registration numberISRCTN72614272; Post-results.

scholarly journals Prevalence of Uncontrolled Blood Pressure in Hypertensive Patients Attending The Primary Care Unit of Songklanagarind Hospital

2018 ◽  
Vol 36 (1) ◽  
pp. 11 ◽  
Author(s):  
Tharntip Sangsuwan ◽  
Silom Jamulitrat
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
High Blood Pressure ◽  
Joint National Committee ◽  
Uncontrolled Hypertension ◽  
National Committee ◽  
Primary Care Unit ◽  
Hypertensive Patients ◽  
Treatment Of Hypertension ◽  
Detection Evaluation

Objective: To evaluate the prevalence of uncontrolled hypertension based on the Thai Guideline on the Treatment of Hypertension 2012, the 7th report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7) and its recently released version, 8th Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC8).Material and Method: We screened 1,311 hypertensive patients who visited the Primary Care Unit at Songklanagarind Hospital from October to December 2013. The outcome of this cross-sectional study was the prevalence of uncontrolled hypertension based on the Thai Guideline on the Treatment of Hypertension 2012, JNC7 and JNC8.Results: The study included a total of 1,181 patients. The prevalences of uncontrolled hypertension were 57.2%, 53.4% and 30.0%, based on the Thai guidelines, JNC7 and JNC8, respectively.Conclusion: The prevalence of uncontrolled hypertension in our setting remained unsatisfactory.

Evaluation of a Pharmacist-Managed Hypertension Clinic in a Rural Primary Care Setting

2020 ◽  
pp. 089719002092684
Author(s):  
Ashley M. Stallings ◽  
Candace Dixon ◽  
Amanda Carter ◽  
Asima Ali ◽  
Charles Herring
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Primary Care Clinic ◽  
Uncontrolled Hypertension ◽  
Care Clinic ◽  
Care Gap ◽  
Hypertension Clinic ◽  
Gap Closure ◽  
Blood Pressures ◽  
The Mean

Objective: To describe clinical pharmacy services provided in a rural North Carolina primary care clinic and assess the impact of these services on systolic and diastolic blood pressures in patients with uncontrolled hypertension. Methods: This single-center, retrospective study evaluated change in systolic and diastolic blood pressures from baseline, percentage of patients with blood pressure reductions, percentage at The Eight Joint National Committee (JNC 8) goal blood pressure, percentage at care gap closure defined as obtaining a blood pressure <140/90 mm Hg, and time to reach care gap closure. Results: The mean change in systolic blood pressure was −20.1 mm Hg (14.716-25.418, P < .0001) and the mean change in diastolic blood pressure was −8.8 mm Hg (5.449-12.117, P < .0001). Eighty percent of patients experienced blood pressure reductions from baseline, 51% met their respective JNC 8 goal blood pressure, and 48% met care gap closure. The average time to reach care gap closure was 23 weeks. Conclusion: When embedded within a primary care clinic in a rural setting, a pharmacist-managed hypertension clinic significantly improved both systolic and diastolic blood pressures of patients with uncontrolled hypertension.

Device therapy of resistant hypertension

2013 ◽  
Vol 154 (6) ◽  
pp. 203-208 ◽  
Author(s):  
Gábor Simonyi ◽  
J. Róbert Bedros ◽  
Mihály Medvegy
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Resistant Hypertension ◽  
Carotid Sinus ◽  
Maximum Tolerated Dose ◽  
Reduce Blood Pressure ◽  
Nerve Fibers ◽  
Uncontrolled Hypertension ◽  
Sympathetic Nerve Fibers ◽  
Treatment Of Hypertension

It is well known that hypertension is an independent cardiovascular risk factor. Treatment of hypertension frequently includes administration of three or more drugs. Resistant hypertension is defined when blood pressure remains above target value despite full doses (the patient’s maximum tolerated dose) of antihypertensive medication consisting of at least three different classes of drugs including a diuretic. Pharmacological treatment of hypertension is often unsuccessful despite the increasing number of drug combinations. Uncontrolled hypertension, however, increases the cardiovascular risk. Device treatment of resistant hypertension is currently testing two major fields. One of them the stimulation of baroreceptors in the carotid sinus and the other is radiofrequency ablation of sympathetic nerve fibers around renal arteries to reduce blood pressure in drug resistant hypertension. Orv. Hetil., 2013, 154, 203–208.

Registered nurse prescribing: A descriptive survey of prescribing practices in a single district health board in Aotearoa New Zealand

2020 ◽  
Vol 36 (3) ◽  
pp. 61-72
Author(s):  
Melinda McGinty ◽  
◽  
Betty Poot ◽  
Jane Clarke ◽  
◽  
...  
Keyword(s):  
Primary Care ◽  
New Zealand ◽  
Registered Nurse ◽  
Health Conditions ◽  
Health Board ◽  
Prescribing Practices ◽  
District Health ◽  
Survey Tool ◽  
Aotearoa New Zealand ◽  
Descriptive Survey

The expansion of prescribing rights in Aotearoa New Zealand has enabled registered nurse prescribers (RN prescribers) working in primary care and specialty teams, to enhance nursing care, by prescribing medicines to their patient population. This widening of prescribing rights was to improve the population’s access to medicines and health care; however, little is known about the medications prescribed by RN prescribers. This paper reports on a descriptive survey of self-reported RN prescribers prescribing in a single district health board. The survey tool used was a Microsoft Excel spreadsheet to record nurse’s area of practice, patient demographic details, health conditions seen, and medicines prescribed and deprescribed. Simple data descriptions and tabulations were used to report the data. Eleven RN prescribers consented to take part in the survey and these nurses worked in speciality areas of cardiology, respiratory, diabetes, and primary care. Findings from the survey demonstrated that RN prescribers prescribe medicines within their area of practice and within the limits of the list of medicines for RN prescribers. Those working in primary care saw a wider range of health conditions and therefore prescribed a broader range of medications. This survey revealed that the list of medications available for RN prescribers needs to be updated regularly to align with the release of evidence-based medications on the New Zealand Pharmaceutical Schedule. It is also a useful record for both educational and clinical settings of the types of medications prescribed by RN prescribers.

Sign in / Sign up

Export Citation Format

Share Document