scholarly journals Remote outpatient follow-up of patients with arterial hypertenson: the role of a nurse

2021 ◽  
Vol 10 (2) ◽  
pp. 84-91
Author(s):  
I. L. Strokolskaya ◽  
D. V. Kilizhekova ◽  
G. V. Artamonova
Keyword(s):  
Arterial Hypertension ◽  
Preventive Measures ◽  
Antihypertensive Drugs ◽  
Medical Personnel ◽  
Target Values ◽  
Urgent Patient ◽  
Number Of Visits ◽  
Coaching Approach

Highlights. Telehealth remote monitoring for patients with arterial hypertension has been developed and implemented. A nurse coaching approach has been reported.Aim. To develop and implement the technology of remote dispensary observation of patients with arterial hypertension (AH) using telemedicine, in which the main performer is a clinic nurse.Methods. The research object is patients with AH who are under dispensary observation at the territorial polyclinic. The study included 183 patients aged 53±12.5 years, of which 64.5% were women. The duration of observation is from 30 to 90 days. The effectiveness was evaluated on the basis of the achievement of target values of blood pressure (BP), number of visits to the doctor for hypertension decompensation, patient compliance. The program used data processing technology applying telemedicine devices for automatic BP measurement.Results. In 75.5% of cases, there was a decrease in the average level of systolic and diastolic BP in comparison with the initial levels. A decrease in the maximum systolic BP and in the frequency of decompensation episodes of BP above 160 mm Hg was recorded in 15.8% of patients. Achievement of the target BP level was identified in 64.2% of patients, in 11.3% there was a positive dynamic in the clinical condition without achieving the target figures, in 24.5% of cases, no dynamics was found. The majority of patients (84.2%) preferred remote forms of counseling while maintaining a stable level of indicators. Among 15.8% of patients, the number of visits to a doctor decreased from 2.0 to 0.75 visits per month. High adherence to preventive measures was observed in 88.7% of cases; 100% of patients in the observation group confirmed the use of prescribed antihypertensive drugs.Conclusion. The original technology of remote dispensary observation of patients with AH using telemedicine devices enhances the continuity in “doctor-nurse-patient” interactions, which contributes to the improvement of medical efficiency by increasing the proportion of patients in the dispensary group who have reached the target level of BP and increase the patients' adherence to preventive measures. Telemedicine technologies reduce the number of scheduled and urgent patient visits to a polyclinic, which is relevant in the context of the shortage of medical personnel and the transition to remote consultation due to the restrictions caused by the epidemic threat [17].

scholarly journals Baroreflex activation therapy for resistant hypertension: results from mid-term prospective ambulatory blood pressure registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Sindt ◽  
T Madej ◽  
S Grimm ◽  
M Knaut
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Pressure Drop ◽  
Arterial Hypertension ◽  
Antihypertensive Drugs ◽  
Drug Resistant ◽  
Baroreflex Activation Therapy ◽  
Activation Therapy ◽  
Resistant Arterial Hypertension

Abstract Objectives First generation baroreflex activation therapy (BAT) devices showed clinical efficacy in patients with drug-resistant arterial hypertension (AHT), but the safety profile was insufficient. Data regarding efficacy of second-generation devices were generated mostly from office blood pressure (BP) measurements or short-term 24-hour ambulatory blood pressure measurements (ABPM). We present a mid-term prospective registry to evaluate the efficacy and safety of recent BAT devices. Purpose The purpose of our study was to find a method that helps patients with drug-resistant arterial hypertension to control their blood pressure. Further we sought to reduce the overall amount of antihypertensive drugs to lessen side effects, as well as the effects of polypharmacy. Methods All patients receiving Barostim neo between November 2013 and June 2019 for resistant AHT were prospectively included into this observational study. ABPM was performed at baseline, in 3-month intervals in the first year after BAT implantation and in 6-month intervals afterwards for up to 42 months. Patients were assigned into two groups of responders and non-responders. Non-responders had a mean blood pressure drop (BPD) below 5mmHg. Responders in turn were categorized into 3 sub-groups (low-BPD between 5–9 mmHg, medium-BPD between 10–19 mmHg and high-BPD ≥20 mmHg). The primary efficacy end-points were changes in systolic and diastolic BP and number of antihypertensive medications. The primary safety end point was BAT-related major adverse events (MAE). Results 64 patients (mean age 63 years, 67% males) were included. Only patients who completed a 24-hour ABPM during a follow up were counted in the statistical analysis. We had an overall responder rate of 67.8%. Out of those 15.4% had low-BPD, 38.4% medium-BPD and 46.2% had a high-BPD. Systolic BP decreased over the 3.5-years period from 168±17 mmHg to 149±19 mmHg (n=19, mean change −18.8 mmHg; 95% confidence interval [CI]: −29.32 to −8.36; p<0.0007). Diastolic BP decreased from 97±16 to 85±12 mmHg (n=19, mean change −11.7 mmHg; 95% CI: −19.2 to −4.2; p<0.0021). The mean number of antihypertensive drugs was reduced from 6.9±1.3 to 5.2±1.5 (n=19, mean change −1.7; 95% CI: −0.8 to −0.27; p<0.0009). The time course of primary end-points is shown in Fig.1. Freedom from BAT-related MAE was 93.5%. 4 perioperative complications (1 pocket bleeding, 1 pocket infection, 1 N. hypoglossus palsy, 1 hoarseness) resolved without residual side effects. There were five non BAT related deaths (7,8%) in the follow up period. Conclusion Systolic and diastolic ABP, as well as number and dosage of antihypertensive drugs decreased significantly during 3.5-years follow-up after Barostim neo implantation in 64 consecutive patients (of whom 62 completed at least one follow-up). No MAE associated with BAT were observed after the perioperative period. However, further controlled trials are needed to confirm the long-term efficacy of BAT. Figure 1. Mean blood pressure drop Funding Acknowledgement Type of funding source: None

scholarly journals The hardness of the vessel wall in patients with arterial hypertension

2015 ◽  
Vol 12 (2) ◽  
pp. 43-48
Author(s):  
O D Ostroumova ◽  
A I Kochetkov ◽  
I I Kopchenov ◽  
T F Guseva ◽  
O V Bondarec
Keyword(s):  
Arterial Hypertension ◽  
Vessel Wall ◽  
Antihypertensive Drugs ◽  
Blood Pressure Level ◽  
Vascular Wall ◽  
Cardiovascular Complications ◽  
Increased Risk ◽  
The Status ◽  
The Difference

The article deals with the role of the hardness of the vessel wall in the pathogenesis of arterial hypertension and its complications and cardiovascular mortality. We discussed the factors increasing the hardness of the vessel wall, such as age, blood pressure level, atherosclerosis, smoking and diabetes mellitus. We showed the indicators reflecting the status of the vascular wall and which could play a role of markers of increased risk of cardiovascular complications. We reviewed the data concerning the improvement of the parameters of the hardness of the vessel wall under the influence of antihypertensive therapy using the angiotensin II type 1 receptor blocker - candesartan. We discussed the possible mechanisms of the candesartan influence on the elastic properties of the vessels. We stressed that the effect on the hardness of the arteries on using antihypertensive drugs, even within the same class, was different, which, apparently, was associated with the difference in the pharmacokinetic properties.

scholarly journals STROKE PREVENTION OPPORTUNITIES FOR CARDIOLOGISTS: COMPLEX MANAGEMENT OF ARTERIAL HYPERTENSION (ROLE OF CALCIUM ANTAGONISTS)

2013 ◽  
Vol 12 (4) ◽  
pp. 79-81
Author(s):  
E. O. Taratukhin
Keyword(s):  
Risk Factors ◽  
Arterial Hypertension ◽  
Calcium Channel Blockers ◽  
Preventive Measures ◽  
Channel Blockers ◽  
Hypertension Treatment ◽  
Therapeutic Approaches ◽  
Antihypertensive Medications ◽  
Multiple Risk Factors

The paper focuses on the important issue of cardio-cerebral interactions, cardiac comorbidities, and the need for complex therapeutic approaches. While stroke is traditionally regarded as a neurologic problem, cardiologists play an important role in its prevention, via modification of multiple risk factors. One of the key preventive measures is arterial hypertension treatment. New calcium channel blockers are a promising group of modern antihypertensive medications. 

scholarly journals THE PIONEERING ROLE OF SHARIA SCHOLARS IN THE CORONA PANDEMIC

2021 ◽  
Vol 03 (03) ◽  
pp. 134-147
Author(s):  
Najwa N. A SHKOKANI
Keyword(s):  
Islamic Law ◽  
Preventive Measures ◽  
Positive Impact ◽  
Islamic History ◽  
Field Approach ◽  
Effective Role ◽  
The Common ◽  
Political Health

The majority of societies on Earth suffered a lot physically, psychologically, intellectually and financially during the Corona Covid-19 epidemic in the period 2020-2021, which surprised everyone with the speed and severity of its spread and lethality all over the world, and with the severity of the preventive measures that forced people to adhere to it. Despite all the crises that accompanied it or resulted from it, the scholars of Sharia, despite their great efforts in the field of fatwas that have taken place, nevertheless the common Muslims felt their lack of a pioneering and effective role for them, for they are the scholars of the ummah. And their deeds rise to the level appropriate to the greatness of Islam and lead it to serve mankind in all circumstances, in all societies and at all times. So did they take advantage of the circumstances and in the jurisprudence councils, legal universities, Islamic think tanks and others, hastened to meet and consult periodically and intensely commensurate with the momentum of the developments that took place in that event and the pursuit of the event in all its aspects and dynamics, and has the effect of this appeared in several aspects in Islamic societies and elsewhere? The Holy Qur’an and the Noble Prophet’s Sunnah have revealed this pioneering role by the prophets and messengers, saints and scholars. Scholars of true law at all times are the heirs of the prophets, and enjoining good and forbidding evil depends on their guidance and diligence. Likewise, that role is not hidden in the wonderful models launched in Islamic societies throughout its prosperous history in all aspects of life, and in all the circumstances and conditions that it has gone through, including calamities, tribulations, misfortunes, strife, diseases and epidemics, which had the greatest positive impact on the Ummah’s awareness and knowledge of good behavior in it. To prevent the largest proportion of the losses in the lives of people and the good of the country. This study comes by following the descriptive and analytical method to highlight the aforementioned by introducing the Corona epidemic, and the inductive approach by exploring the pioneering role of true Islamic law scholars in epidemics by referring to the sources of legislation with evidence of that throughout Islamic history, then searching for that application in this era, following the field approach Al-Estebyani, with investigating their positions during that epidemic. The most prominent results after the research were: That Islamic scholars have the greatest importance that goes beyond the intellectuals, thinkers, and even politicians, and they are at the forefront of society in researching and uncovering how to deal with epidemics according to Sharia evidence, using all means and techniques, both ancient and modern. And adopting educational, informational and advocacy methods in generalizing how people deal with the epidemic; And to highlight the faith role that achieves security, tranquility, and satisfaction with the judgment of God, adhering to the teachings of Islam in that event and responding to the responsible represented by the intellectual, political, health and other systems, and they also have a great impact on societies when they rush to issue fatwas to guide individuals and governments in how to deal with this pandemic, and not to stop Then, it is imperative to constantly and diligently follow up on the developments of the epidemic with the permanent meeting of fatwa councils locally and internationally, in order to change the fatwas and procedures in line with the new circumstances. That Muslim scholars have been the pioneering and guiding reed throughout history represented by models that elevated themselves, their nation, and humanity as well.

The effect of educational programs on effectiveness of treatment of arterial hypertension at out-patient stage of medical care rendering

2016 ◽  
Vol 22 (4) ◽  
pp. 207-212
Author(s):  
Aleksandr V. Melekhov ◽  
E. I Emelina ◽  
O. Yu Andreeva ◽  
G. E Gendlin ◽  
L. V Sokolovskaya
Keyword(s):  
Arterial Pressure ◽  
Arterial Hypertension ◽  
Educational Program ◽  
Systolic Arterial Pressure ◽  
Educational Programs ◽  
Self Control ◽  
Target Values ◽  
Mercury Column ◽  
Hypotensive Therapy

The increasing of effectiveness of treatment of arterial hypertension is a key issue of prevention of complications of this disease. The level of target arterial pressure is achieved far from all patients treated because of arterial pressure. The article presents data concerning 55 individuals with office systolic arterial pressure higher than 140 mm of mercury column who in spite of hypotensive therapy prescribed by physician, demonstrated no achievement of target values of arterial pressure. Out of this group, 24 patients were acquainted with educational program including an hour lecture concerning arterial hypertension, techniques of self-control of arterial pressure, effect of non-pharmaceutical modes of treatment and role of patients themselves in therapy of this diseases. The educational program was ignored by 31 patient. All patients at the start and the completion of examination were measured office arterial pressure, monitored day arterial pressure. Also evaluation of compliance to indicated hypotensive medicinal therapy was carried out. At the second control visit after 1-3 months, in patients who attended the lecture, significant decreasing of arterial pressure was established according both office measurement and data of indices of systolic arterial pressure. Moreover, the same patients developed compliance to applied treatment. No such effects were observed in 31 patients who ignored lecture mentioned above. It is assumed that the important part of activities concerning treatment of patients with arterial hypertension from the very beginning of interaction with physician is to become increasing of awareness of patients about disease, modes of its control, importance of non-medicinal measures, regular pharmacotherapy attended by physician. It is appropriate to actively implement these measures in practical health care considering expressed clinical and social economical effectiveness of educational programs for patients with arterial hypertension.

scholarly journals The role of life exhaustion in the development of arterial hypertension in 25-64-year-old men: Epidemiological survey based on the WHO program "MONICA"

2004 ◽  
Vol 10 (3) ◽  
pp. 158-160
Author(s):  
V. V. Gafarov ◽  
Ye. A. Gromova ◽  
I. V. Gagulin ◽  
A. V. Gafarova
Keyword(s):  
Relative Risk ◽  
Arterial Hypertension ◽  
Response Rate ◽  
Fold Increase ◽  
Epidemiological Survey ◽  
Old Men ◽  
Screening Survey ◽  
Social Level

Aim. To study i lie impact of life exhaustion on the risk for the development of arterial hypertension (AH) in 25-64-year-old men for 6 years. Subjects and methods. In 1994, a screening survey was performed within the framework of the WHO program "MONICA - psychosocial". A random representative sample of males (n = 657) aged 25-64 years who resided in one of the Novosibirsk districts was examined. The response rate was 82.1 %. The follow-up lasted 6 years (1904-2000). A statistical analysis was made, by using a "SPSS-10" program package. The Cox-proportional regression model was used to assess the relative risk of AH. The c_ test was applied to estimate the significance of differences between the groups. Results. In the examined population of 25-64-year-old men suffering from AH. the spread of life exhaustion is high and equal to 73-796 (mean 58 %; the high life exhaustion is 15.796): During the 6-year follow-up. there was a trend for the risk of AH to show a 2-fold increase in the exhausted males. The relative risk of AH. which was studied in normotensive males aged 25-64 years dining 6 years, was 2 times higher in the exhausted individuals than that in the unexhausted ones. Among the exhausted males, there were both persons having a higher education or holding leading posts and those having a primary education, or making hard and moderate work; pensioners, and individuals at the low social level. Conclusion. The findings suggest that life exhaustion is a pathogenetic mechanism that contributes to the development of AH.

scholarly journals PATIENTS` AWARENESS ABOUT ARTERIAL HYPERTNESION. THE ROLE OF NURSE STAFFING

2020 ◽  
Vol 1 (1) ◽  
pp. 32-39
Author(s):  
H.H. Mararash
Keyword(s):  
Blood Pressure ◽  
Preventive Measures ◽  
Nurse Staffing ◽  
Preventive Healthcare ◽  
Healthy Life ◽  
Healthy Life Style ◽  
Key Aspects

Purpose: to evaluate the patients` awareness about arterial hypertension (HYP), and to clarify the role of nurse staffing in HYP prevention. Material and methods. We enrolled 120 HYP patients receiving follow-up care in Municipal Out-Patients` Clinic #1 (males – 43,3 %, females – 56,7 %; age ranged from 23 to 79 years). The awareness about HYP was evaluated by means of questioning. All the enrolled patients participated in the survey. Along with the survey, we performed blood pressure check and discussed with patients the issues regarding healthy life-style, risk factors modification and the potential HYP complications. Survey data analysis was performed by the use of Statistica v. 10.0 software package. Results and discussion. The HYP anamnesis duration was characterized by significant variation. The majority of respondents (82 %) pointed at HYP duration more than 10 years. The blood pressure checking revealed the predominance of degrees 1 and 2 of HYP. About the half of patients (n=59 [49,2 %]) were aware of their health status due to the long-term disease, along with 48 (40,0 %) patients who were insufficiently aware of their condition. Finally, 13 (10,8 %) patients had lacked interest in their disease, suggesting the passive and irresponsible attitude towards their own health. Conclusions. The effectiveness of preventive healthcare, as one the nurse staffing activities, is influenced by the following factors: key aspects, format and levels of preventive measures; patient-nurse partnership; material and technical support; patients` needs and interests; and the nurse`s ability to be creative.

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