scholarly journals The role of non-drug methods of increasing adherence to the treatment of patients with arterial hypertension in a polyclinic

2022 ◽  
pp. 16-25
Author(s):  
S. S. Simenyura ◽  
Zh. M. Sizova
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Heart Diseases ◽  
Blood Pressure Monitoring ◽  
Self Monitoring ◽  
Average Systolic Blood Pressure ◽  
High Risk Factors ◽  
Treatment And Prevention ◽  
Questionnaire Surveys ◽  
The Impact

Introduction. Arterial hypertension (AH) is one of the important high-risk factors for the development of heart diseases, but its diagnosis and treatment does not require high technologies and substantial costs. However, the asymptomatic course of AH combined with a low level of medical literacy contributes to low adherence to treatment.Aim. To study the indirect impact of remote blood pressure monitoring (RBPM), the introduction of educational materials (EMs) in comparison with self-monitoring of blood pressure (SMBP) on adherence of patients with AH to outpatient treatment.Materials and methods. 60 subjects with an established fact of partial or complete refusal to use antihypertensive therapy were enrolled in the study and randomized into four equal and comparable groups: 1 – SMBP, 2 – RBPM, 3 – SMBP + EMs, 4 – RBPM + EMs. The impact of using RBPM was assessed by comparing blood pressure values in groups 1 and 2; the impact of EM – by comparing the results of questionnaire surveys in groups 1 and 2 and groups 3 and 4.Results and discussion. Additional training of patients with AH contributed to a twofold increase in adherence in using SCAD and RBPM. The average systolic blood pressure in groups 1 and 2 was 134 mm Hg, in groups 3 and 4 – 129 mm Hg; diastolic blood pressure in groups 1 and 2 – 78.5 mm Hg, in groups 3 and 4 – 77.5 mm Hg.Conclusion. The maximum impact on adherence to AH treatment can be achieved with the introduction of a set of measures. However, the introduction of RBPM has a number of limitations associated with the additional economic burden and the lack of an approved methodology. However, the provision of treatment and prevention facilities with EMs does not require additional development of methodology and is significantly cheaper than the cost of modern blood pressure monitors.

scholarly journals Self home blood pressure monitoring in pregnancy: how reliable is it?

2018 ◽  
Vol 7 (2) ◽  
pp. 419
Author(s):  
Hemapriya L. ◽  
Nagaraj Desai ◽  
Ambarish Bhandiwad
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
Self Monitoring ◽  
Medical College ◽  
The Mean ◽  
The Difference ◽  
A Prospective Study ◽  
The Impact ◽  
In Pregnancy

Background: The use of automated blood pressure monitors in pregnancy has become increasingly popular, as more women tend to get involved in their healthcare. Not only does it reduce clinician visits, it also helps to eliminate the white coat hypertension.Methods: We conducted a prospective study in the antenatal department of JSS Medical College and Hospital, Mysuru; over a period of one year, from July 2016 to June 2017. The blood pressures of 50 women were recorded at four different periods of gestation using the conventional ‘Diamond mercury Sphygmomanometer’ versus the automated ‘Omron HEM 7130’ home BP monitor and compared.Results: The recordings of systolic blood pressure at home were consistently less than the office measurements at all periods of gestation. However, the difference was not statistically significant. The comparison of diastolic pressures revealed minimal variations between the mean of the office and home blood pressure recordings. The mean arterial pressure also revealed a similar trend.Conclusions: Self-monitoring of blood pressure is a feasible and acceptable option to pregnant women. It might make antenatal care more effective, but we need further research to establish safety and efficacy, the impact on women and health professionals, and how best to use the results.

scholarly journals Home Blood Pressure Monitoring

2015 ◽  
Vol 10 (2) ◽  
pp. 95 ◽  
Author(s):  
Jacob George ◽  
Thomas MacDonald ◽  
◽  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
New Technology ◽  
Home Blood Pressure ◽  
White Coat Hypertension ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Self Monitoring ◽  
Reading Accuracy ◽  
The Impact

Hypertension is the most common preventable cause of cardiovascular disease. Home blood pressure monitoring (HBPM) is a self-monitoring tool that can be incorporated into the care for patients with hypertension and is recommended by major guidelines. A growing body of evidence supports the benefits of patient HBPM compared with office-based monitoring: these include improved control of BP, diagnosis of white-coat hypertension and prediction of cardiovascular risk. Furthermore, HBPM is cheaper and easier to perform than 24-hour ambulatory BP monitoring (ABPM). All HBPM devices require validation, however, as inaccurate readings have been found in a high proportion of monitors. New technology features a longer inflatable area within the cuff that wraps all the way round the arm, increasing the ‘acceptable range’ of placement and thus reducing the impact of cuff placement on reading accuracy, thereby overcoming the limitations of current devices.

Ambulatory blood pressure monitoring-based definition of true arterial hypertension

2020 ◽  
Vol 111 (6) ◽  
Author(s):  
Ramón C. Hermida ◽  
Artemio Mojón ◽  
José R. Fernández ◽  
Alfonso Otero ◽  
Juan J. Crespo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Definition Of

Modern approach to the treatment of arterial hypertension

2021 ◽  
pp. 28-34
Author(s):  
Dmitriy Sergeevich Kovalev
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Arterial Hypertension ◽  
Pathological Condition ◽  
Cardiovascular Complications ◽  
European Population ◽  
Modern Approach ◽  
Appropriate Treatment ◽  
Literary Sources ◽  
The Impact

Arterial hypertension (AH) refers to an increase in blood pressure above the level of 140/90 mm Hg; the risk of cardiovascular complications increases significantly with this pathological condition. Thus, arterial hypertension is an independent risk factor for the development of prediabetes / type 2 diabetes mellitus, heart failure, coronary heart disease, chronic kidney damage, and multifocal atherosclerosis. The frequency of arterial hypertension occurrence varies in different countries: in particular, it is from 23 to 36% for the European population, according to various literary sources. The main goal of treatment is to minimize the overall risk of developing cardiovascular complications. This involves the impact on all identified reversible risk factors, such as smoking and high cholesterol levels, and most importantly, appropriate treatment of concomitant diseases (diabetes mellitus, thyroid gland pathology, kidney disease, etc.), as well as the correction of high blood pressure.

scholarly journals The Key Role of Ambulatory Blood Pressure Monitoring in the Detection of Masked Hypertension and Other Phenomena in Frail Geriatric Patients

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1221
Author(s):  
Marek Koudelka ◽  
Eliška Sovová
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Geriatric Patients ◽  
Blood Pressure Monitoring ◽  
Target Range ◽  
Masked Hypertension ◽  
Pressure Monitoring

Background and Objectives: This study aims to determine prevalence of masked uncontrolled hypertension (MUH) in frail geriatric patients with arterial hypertension and thus show the role of ambulatory blood pressure monitoring (ABPM) since hypertension occurs in more than 80% of people 60+ years and cardiovascular diseases are the main cause of death worldwide. Despite modern pharmacotherapy, use of combination therapy and normal office blood pressure (BP), patients’ prognoses might worsen due to inadequate therapy (never-detected MUH). Materials and Methods: 118 frail geriatric patients (84.2 ± 4.4 years) treated for arterial hypertension with office BP < 140/90 mmHg participated in the study. 24-h ABPM and clinical examination were performed. Results: Although patients were normotensive in the office, 24-h measurements showed that BP values in 72% of hypertensives were not in the target range: MUH was identified in 47 (40%) patients during 24 h, in 48 (41%) patients during daytime and nocturnal hypertension in 60 (51%) patients. Conclusions: ABPM is essential for frail geriatric patients due to high prevalence of MUH, which cannot be detected based on office BP measurements. ABPM also helps to detect exaggerated morning surge, isolated systolic hypertension, dipping/non-dipping, and set and properly manage adequate treatment, which reduces incidence of cardiovascular events and contributes to decreasing the financial burden of society.

scholarly journals COGNITIVE IMPAIRMENT, THEIR DYNAMICS AND STRUCTURE IN THE ACUTE AND RECOVERY PERIODS OF STROKE, DEPENDING ON ARTERIAL HYPERTENSION SEVERITY AND DURATION

2018 ◽  
Vol 13 (3-4) ◽  
pp. 22-27
Author(s):  
T.M. Cherenko ◽  
Yu.L. Heletyuk
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Cognitive Status ◽  
Neurological Deficits ◽  
Stroke Patients ◽  
Mean Values ◽  
Post Stroke ◽  
The Mean

Relevance. Cognitive impairment is common in the post-stroke period. Different characteristics of arterial hypertension (AH), namely its severity, duration and variability of blood pressure, can affect the development of cognitive impairment in stroke patients. Objective: to investigate cognitive impairment, their dynamics and structure in acute and recovering stroke periods, depending on the arterial hypertension severity and duration. Materials and methods. 150 patients with a primary ischemic stroke and history of hypertension: 74 (49,3 %) women and 76 (50,7 %) men, the mean age (67,4±0,7) years have been examined. Neurological deficits was evaluated by the NIHSS scale. The cognitive status was evaluated by the MMSE scale at the end of an acute period of 21 days and 1 year. Diagnosis of hypertension was based on the clinical and instrumental examination results and medical documents. Daily blood pressure monitoring was using on admission and every 4 hours during 6 days of acute stroke stage. Mean SBP, mean DBP, maximum SBP and DBP, standard deviation (SD) of SBP and DBP were studied. Results. By the mean score on the MMSE scale, there are differences in patients during acute post-stroke period, depending on the severity of hypertension: 27,2±0,6 points in the case of hypertension stage 1, 24,3±0,6 in the case of hypertension stage 2 and 20,7±0,8 in case of AH stage 3, (p=0.001). By this indicator, patients with different AH duration were different: 26,4±0,9 points; 25,1±0,5 points; 20,5±0,7 points, respectively. The significance of these differences by the mean values of MMSE score was obtained in patients with a duration of AH less than 5 years and more than 10 years, as well as when comparing the group of "6-10 years" and "over 10 years" (p=0,001). Significant differences in the structure of cognitive deficits severity, depending on the hypertension stage and its duration, were observed only in patients with moderate and severe stroke (p=0,006). Cognitive deterioration a year after a stroke was observed in 40 (31,5 %) patients. They have significantly higher mean values SD 1-3, SD 1-6, SBP on the first day after a stroke, and duration of hypertension. Conclusions. The relationship between the degree of intellectual decline and the duration of hypertension (r=0,592, p=0,001), severity of hypertension (r=0,459, p=0,001) was found. The severity of the neurological deficiency affects the structure of cognitive impairment at discharge in patients with different severity and duration of hypertension, and higher mean values of the variability of blood pressure from 1 to 6 days, SBP on the first day after stroke and higher duration of hypertension in the history is associated with a negative dynamics of cognitive impairment in stroke patients in a year after stroke.

scholarly journals Single Pill Indapamide and Perindopril Arginine Combination: Optimal Coupling of Vascular Protection and Hemodynamic Risk Factors Reduction in Patients with Essential Arterial Hypertension

Kardiologiia ◽  
2019 ◽  
Vol 59 (3) ◽  
pp. 18-26 ◽  
Author(s):  
E. V. Borisova ◽  
A. I. Kochetkov ◽  
O. D. Ostroumova
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Arterial Hypertension ◽  
Arterial Compliance ◽  
Stage Ii ◽  
Stiffness Index ◽  
Single Pill ◽  
Essential Arterial Hypertension ◽  
The Impact

Objective: to investigate the impact of indapamide / perindopril single-pill combination (I / P SPC) on arterial stiffness parameters, blood pressure (BP) level and BP variability (BPV) in middle-aged patients with stage II grade 1–2 essential arterial hypertension (EAH). Materials and methods. We retrospectively formed a group of patients with stage II grade 1–2 EAH who had not previously received regular antihypertensive therapy (AHT) (n=52, mean age 52.9±6.0 years). All patients were treated with I / P SPC and all of them achieved target office BP level (less than 140 / 90 mm Hg). After 12 weeks of follow-up (from the time of reaching the target BP) assessment of AHT effectiveness (general clinical data, ambulatory blood pressure monitoring [ABPM], volume sphygmography, echocardiography), and vascular stiffness evaluation were performed.Results. At the end of follow-up office systolic BP (SBP), diastolic BP (DBP), pulse BP, day-time, night-time and 24‑hour SBP and DBP significantly (p<0.001 for all) decreased. According to the ABPM data day-time, nighttime, and 24‑hour systolic BPV significantly decreased (p=0.029, p=0.006 and p<0.001, respectively); day-time and 24‑hour diastolic BPV also significantly decreased (p=0.001 and p<0.001, respectively). Day-night standard deviation (SDdn) significantly decreased too (p=0.002 and p<0.001, respectively). Volumetric sphygmography showed significant decrease of right cardio-ankle vascular index (CAVI) (from 8.20±1.29 to 7.58±1.44, p=0.001) and of left CAVI (from 8.13±1.40 to 7.46±1.43, p<0.001), as well as reduction of the number o f patients with a right- and / or left-CAVI >9.0 (from 32.7 to 11.5 %, p=0.018). According to assessment of arterial stiffness using the Vasotens24 software package, the arterial stiffness index (ASI) significantly (p<0.001) decreased from 153.5±29.9 to 138.3±20.0 (by –9.2±13.1 %). Transthoracic echocardiography data demonstrated significant decrease (p<0.001) in effective arterial elastance (from 1.82±0.43 to 1.58±0.36 mm Hg; by –11.85±16.29 %) and significant (p<0.001) increase in the arterial compliance – from 1.27±0.34 to 1.54±0.38 mm Hg / ml (+26.95±38.06 %).Conclusion. In AHT naive patients 40–65 years old with stage II grade 1–2 EAH therapy with I / P SPC provided effective 24‑hour BP control, reduced BPV and improved arterial stiffness parameters. 

scholarly journals Blood pressure profile, structural and functional cardiac parameters, renal function and metabolic status in hypertensive patients with chronic secondary pyelonephritis

2010 ◽  
Vol 16 (3) ◽  
pp. 256-260 ◽  
Author(s):  
M. E. Statsenko ◽  
M. V. Derevjanchenko
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Close Relation ◽  
Pressure Profile ◽  
Upper Urinary Tract ◽  
Chronic Pyelonephritis ◽  
Metabolic Status ◽  
Hypertensive Patients

Objective. To study the blood pressure variability, morphofunctional parameters of the heart, kidney and metabolic status in hypertensive patients with secondary chronic pyelonephritis. Design and methods. The study included 110 patients: 55 patients with arterial hypertension and secondary chronic pyelonephritis, who underwent surgery for upper urinary tract, and 55 patients with essential arterial hypertension. All patients underwent 24-hour blood pressure monitoring, echocardiography; relative urine density in the morning urine portion, microalbuminuria, blood creatinine were assessed, glomerular fi ltration rate was calculated using MDRD formula. Results. Patients with arterial hypertension and chronic pyelonephritis have signifi cant changes of the blood pressure profi le, and hypertrophy and diastolic left ventricle dysfunction are more frequently observed in this group. A close relation between renal function and the state of the cardiovascular system is established. We also found higher numbers of total cholesterol, the most atherogenic fractions of cholesterol and triglycerides in this group compared to patients with essential hypertension.

scholarly journals Dificuldades no Acompanhamento de Portadores de Hipertensão Arterial Sistêmica Utilizando a Ferramenta de Monitoramento Residencial da Pressão Arterial / Difficulties in Monitoring Patients with Systemic Arterial Hypertension Using the Home Blood Pressure Monitoring Tool

2021 ◽  
Vol 15 (54) ◽  
pp. 448-456
Author(s):  
Josicleiton Morais de Lima ◽  
Amanda Camboim De Sá Santos ◽  
João Paulo Soares Rafael ◽  
Victor Lucas Avelino Galindo ◽  
Milena Nunes Alves de Sousa
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
Home Blood Pressure Monitoring ◽  
Monitoring Tool ◽  
Pressure Monitoring ◽  
Electronic Library ◽  
Systemic Arterial Hypertension

  Resumo: O objetivo deste trabalho foi identificar as principais dificuldades encontradas no acompanhamento dos portadores de Hipertensão Arterial Sistêmica (HAS) utilizando a ferramenta MRPA, bem como as vantagens e eficácia do tratamento ao hipertenso. Foi realizado o levantamento dos artigos científicos nas bases de dados eletrônicas Google Acadêmico e Scientific Electronic Library Online. Após a inserção dos critérios de inclusão e exclusão foram selecionados dez estudos publicados entre 2005 e 2020 para compor a amostra. As dificuldades apontadas na literatura foram: o declínio do uso da ferramenta em longo prazo, dificuldade no manuseio do aparelho, número insuficiente de medidas pelos pacientes dos estudos e indução de estresse e ansiedade nos pacientes. Além disso, foram averiguadas vantagens do uso da ferramenta e a eficácia desse tipo de monitorização no tratamento ao portador de HAS. A ferramenta MRPA é eficaz no diagnóstico e acompanhamento de hipertensos, e para melhor usufruir dessa estratégia, é preciso que os profissionais estejam atentos às dificuldades apontadas e solucioná-las.   

scholarly journals Arterial hypertension: Modern problems

2017 ◽  
Vol 95 (7) ◽  
pp. 581-585
Author(s):  
Igor N. Bokarev ◽  
P. A. Dulin ◽  
Yu. V. Ovchinnikov ◽  
V. B. Simonenko
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Hypertensive Crisis ◽  
Elevated Blood ◽  
Pressure Monitoring ◽  
Hypertensive Disease ◽  
Early Stages ◽  
Hypertensive Crises

Arterial hypertension (AH) is one of the most common diseases. Despite numerous studies, many problems related to this pathology remain to be elucidated. The modern classifications of AHare contradictory and true causes of elevated blood pressure (BP) are unknown. There are no methods for diagnostics of early stages of AH nor is there adequateunderstanding of what hypertensive crises are, how they are to be classified and why they develop. Pathomorphosis of AH is practically unexplored. There are no efficient medications and therapies for the radical treatment of AH. The authors propose classification of hypertensive crisis, hypertensive disease, and symptomatic AH. It is recommended to use 24-hour blood pressure monitoring in all AH patients. New approaches to diagnostics of early stages of AH are proposed.

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