Reproducibility of postural changes of blood pressure in hypertensive elderly patients in primary care

2006 ◽  
Vol 11 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Luis Vara-Gonza??lez ◽  
Sergio Arauzo Alonso ◽  
Rosa M. Gonza??lez Ferna??ndez ◽  
Mar Mar??n-Gil Vecilla ◽  
Nuria Virseda Mar??n ◽  
...  
Author(s):  
Elaine Lau ◽  
Janusz Kaczorowski ◽  
Tina Karwalajtys ◽  
Lisa Dolovich ◽  
Mitchell Levine ◽  
...  

2013 ◽  
Vol 37 (2) ◽  
pp. 166-171 ◽  
Author(s):  
Gustavo C Rodriguez-Roca ◽  
◽  
Jose L Llisterri ◽  
Miguel A Prieto-Diaz ◽  
Francisco J Alonso-Moreno ◽  
...  

2021 ◽  
Author(s):  
Luanna Gabriella Resende da Silva ◽  
Athos Wellington da Silva Resende ◽  
Warlen Eduardo de Resende ◽  
Cleiton Cláudio Resende ◽  
Carine Raquel Blatt ◽  
...  

Abstract Background: Inappropriate use of clonazepam by the elderly patients is associated with cognitive impairment, delirium and falls. Strategies to optimize its use are important to increase patient safety. Objective: To evaluate the feasibility of a clonazepam deprescription protocol in the elderly. Methods: This is a quasi-experimental study. Elderly people with chronic use of clonazepam and attended in primary care units in two Brazilian municipalities were selected. A deprescription protocol was used, which included five fortnightly meetings between the older adults and the research team, to reduce the dose by 25 %. Patients received instructions on sleep hygiene behaviors and the advantages of clonazepam deprescription; family physicians followed a flowchart for gradual dose reduction. In the 1st and 5th meetings, there were medical appointments for anamnesis and discharge. The monitoring of patients and the application of tests were carried out by the research team. Results: Of the 35 elderly people included in the study, 27 reached the end; 81.5 % achieved deprescription: 22.2 % stopped completely and 59.3 % decreased the dose. At the last meeting, 20 % of elderly patients reported an increase in blood pressure. Conclusions: The high rate of deprescription and the little relevance of clonazepam withdrawal reactions, showed that the use of the protocol was effective. However, the increase in blood pressure and the worsening of sleep quality in the last meeting show the need for adjustment in the last stage of the deprescription process.Trial Registration: The Brazilian Registry of Clinical Trials (ReBEC) RBR-524ys9; registered June 10, 2019.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Palmieri ◽  
S Vannucchi ◽  
C Lo Noce ◽  
A Di Lonardo ◽  
B Unim ◽  
...  

Abstract Background Italian National Prevention Plan 2005-08 included 10-year cardiovascular risk assessment (10-CR) for the general population aged 35-69 years using the CUORE Project risk score. GPs were encouraged to perform 10-CR and send data to the Cardiovascular Risk Observatory (CRO). Aim To show updated data of the ongoing surveillance system of the 10-CR in the Italian adult population. Methods Data were collected using the cuore.exe software, freely downloadable by GPs from the CUORE Project website (www.cuore.iss.it). The CRO provides a web-platform to compare data on 10-CR and risk factors at regional/national level. For persons examined at least twice, variations in risk factors from baseline to follow-up and 95% confidence intervals (C.I.) were calculated using methods for matched pair samples. Results Up to February 2019, about 3,500 GPs downloaded cuore.exe; about 300,000 CR assessments on about 140,000 persons were sent to CRO. Mean CR was 3.1% in women (W), 8.5% in men (M); 28% of M, 64% of W were at low risk (CR < 3%); 9.9% of M, 0.4% of W were at high risk (CR ≥ 20%); 26% of M, 16% of W were current smokers; 13% of M, 10% of W were diabetic; 33% of hypertensive M, 35% of hypertensive W were under specific treatment. Among those with at least two risk assessments (31% of the sample), 11% shifted to a lower risk class after one year (14% of M, 7% of W). Systolic blood pressure mean levels decreased by 0.6 mmHg (95%-C.I. 0.3-0.8 mmHg), diastolic blood pressure by 0.5 mmHg (0.2-0.7 mmHg), total cholesterol by 4.1 mg/dl (3.0-5.2 mg/dl), smokers prevalence by 3.1% (2.3%-4.0%); HDL-cholesterol increased in W by 0.3 mg/dl (0.1-0.5 mg/dl). Conclusions Data demonstrate that 10-CR assessment can be an effective first step to implement preventive actions in primary care. Individual risk score is a useful tool for GPs to assess CR and promote primary prevention focusing on the adoption of healthy lifestyles. Data can be used to support health policy decision process. Key messages The cuore.exe software, freely downloadable from the CUORE Project website-www.cuore.iss.it, allows GPs to assess the CUORE Project risk score, to collect and to send data to the CVD Risk Observatory. 10 year Cardiovascular Risk assessment in the general adult population can be an effective first step to implement preventive actions in primary care.


2007 ◽  
Vol 9 (5) ◽  
pp. 324-329 ◽  
Author(s):  
Vivencio Barrios ◽  
Carlos Escobar ◽  
Alberto Calderón ◽  
José L. Llisterri ◽  
Rocio Echarri ◽  
...  

2013 ◽  
Vol 39 (5) ◽  
pp. 418-423 ◽  
Author(s):  
J. Talfournier ◽  
J. Bitu ◽  
C. Paquet ◽  
C. Gobron ◽  
P.J. Guillausseau ◽  
...  

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