scholarly journals ASSESSMENT OF PROFESSIONAL’S ADHERENCE TO JOINT NATIONAL COMMITTEE 8 GUIDELINES IN THE MANAGEMENT OF HYPERTENSION

2019 ◽  
Vol 12 (1) ◽  
pp. 101
Author(s):  
Schnell Jennifer D’souza ◽  
Ancel Neethu Mani ◽  
Nimisha Kurian ◽  
Jaikanth C
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
General Medicine ◽  
Joint National Committee ◽  
Optimal Choice ◽  
National Committee ◽  
Care Hospital ◽  
Antihypertensive Medications ◽  
Dialysis Unit ◽  
Pressure Threshold

Objectives: Hypertension is the most insidious ailment in primary care with its management being a daily affair. The avail of antihypertensive medications has affirmed their efficacy in blood pressure alleviation. Yet, the methodical choice of medication with which treatment ought to commence at the precise blood pressure threshold and maintained at a target level was undiscerned. Consequently, the Eighth Joint National Committee grants an evidence-based tool, which was employed in the appraisal of professional’s adherence to joint national committee 8 guidelines.Methods: A prospective, observational study was governed. Aggregate patients with hypertension with/without diabetes mellitus (DM) and/ or chronic kidney failure admitted in general medicine and the dialysis unit of the tertiary health care hospital, for 4 months were enrolled. The rationality of antihypertensive medications and target blood pressure was noted.Results: Patients matriculated to 125, 90 males and 35 females. Average age perceived was between 51 and 60 years, with the length of stay 14.39 (standard deviation [SD]±1.52) and 9.3 (SD±0.46) days in the respective unit. The gross medication endorsed represents 1085 medications, incorporating 337 antihypertensive medications. The optimal choice of an antihypertensive medicine was clonidine and amlodipine. Adherence in the populace with lone hypertension was cent percent, trailed by hypertension with DM 82.35% and minimal in hypertension with chronic kidney disease.Conclusion: 86-medication compiled adherence to the guidelines (25.52%). Rationality of medication depicts 25.6% were rational and 73.6% distinguish as non-rational, amid a demise of a sole victim. A significant high-grade defiance of health-care practitioners to the Eighth Joint National Committee guidelines was evidenced from our study.

scholarly journals ASSESSMENT OF PROFESSIONAL’S ADHERENCE TO JOINT NATIONAL COMMITTEE 8 GUIDELINES IN THE MANAGEMENT OF HYPERTENSION

2019 ◽  
Vol 12 (1) ◽  
pp. 101
Author(s):  
Schnell Jennifer D’souza ◽  
Ancel Neethu Mani ◽  
Nimisha Kurian ◽  
Jaikanth C
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
General Medicine ◽  
Joint National Committee ◽  
Optimal Choice ◽  
National Committee ◽  
Care Hospital ◽  
Antihypertensive Medications ◽  
Dialysis Unit ◽  
Pressure Threshold

Objectives: Hypertension is the most insidious ailment in primary care with its management being a daily affair. The avail of antihypertensive medications has affirmed their efficacy in blood pressure alleviation. Yet, the methodical choice of medication with which treatment ought to commence at the precise blood pressure threshold and maintained at a target level was undiscerned. Consequently, the Eighth Joint National Committee grants an evidence-based tool, which was employed in the appraisal of professional’s adherence to joint national committee 8 guidelines.Methods: A prospective, observational study was governed. Aggregate patients with hypertension with/without diabetes mellitus (DM) and/ or chronic kidney failure admitted in general medicine and the dialysis unit of the tertiary health care hospital, for 4 months were enrolled. The rationality of antihypertensive medications and target blood pressure was noted.Results: Patients matriculated to 125, 90 males and 35 females. Average age perceived was between 51 and 60 years, with the length of stay 14.39 (standard deviation [SD]±1.52) and 9.3 (SD±0.46) days in the respective unit. The gross medication endorsed represents 1085 medications, incorporating 337 antihypertensive medications. The optimal choice of an antihypertensive medicine was clonidine and amlodipine. Adherence in the populace with lone hypertension was cent percent, trailed by hypertension with DM 82.35% and minimal in hypertension with chronic kidney disease.Conclusion: 86-medication compiled adherence to the guidelines (25.52%). Rationality of medication depicts 25.6% were rational and 73.6% distinguish as non-rational, amid a demise of a sole victim. A significant high-grade defiance of health-care practitioners to the Eighth Joint National Committee guidelines was evidenced from our study.

scholarly journals Assessment of achieved systolic blood pressure in newly treated hypertensive patients aged 60–79 years before and after Eighth Joint National Committee recommendations

2016 ◽  
Vol 11 (2) ◽  
pp. 63-71
Author(s):  
Michael S. Kelly ◽  
Joseph J. Saseen ◽  
Joel C. Marrs
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Systolic Blood Pressure ◽  
Antihypertensive Therapy ◽  
Joint National Committee ◽  
National Committee ◽  
Antihypertensive Medications ◽  
Primary Care Clinics ◽  
University Of Colorado ◽  
The Mean

Objective: To determine whether patients who were newly prescribed antihypertensive therapy after the Eighth Joint National Committee (JNC 8) update were treated to a relaxed systolic blood pressure (SBP) goal compared with patients treated before the update. Methods: A retrospective cohort study approved by the Colorado Multiple Institutional Review Board. Patients aged 60–79 years, without diabetes or chronic kidney disease (CKD), newly treated for hypertension at a University of Colorado primary care clinics were included. The mean first-achieved and last-stable SBPs of patients newly prescribed antihypertensive medications from 1 January 2012 to 31 December 31 2013 (before cohort) were compared with patients newly prescribed antihypertensive therapy from 1 January 2014 to 1 October 2015 (after cohort). The mean number of antihypertensive medications at first-achieved SBP, the time to first-achieved SBP, and the class of initial antihypertensive medications were also evaluated. Results: A total of 128 patients were included, 64 patients in each cohort. The coprimary outcome of first-achieved mean SBP did not differ between the groups (131.3 mmHg versus 130.2 mmHg; p = 0.65). Last-stable mean SBP values were also similar between the groups (130.2 mmHg versus 129.5 mmHg; p = 0.74). Angiotensin converting enzyme inhibitors (ACE-I) were the most frequently initiated antihypertensive agent in both cohorts (43.8% versus 48.4%; p = 0.72). Conclusions: Our findings suggest that the JNC 8 recommendations did not alter SBP goals among patients aged 60–79 years newly treated for hypertension at University of Colorado primary care clinics.

A Comparative clinical evaluation of Sirodhara with Sukhosnajala, Tila Tailam and Brahmi Tailam in the management of mild to moderate essential hypertension

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Bhargavi M ◽  
Shilpa PN ◽  
K. Chaithanya
Keyword(s):  
Essential Hypertension ◽  
Clinical Evaluation ◽  
Lifestyle Modification ◽  
Medical Science ◽  
Initial Therapy ◽  
Joint National Committee ◽  
Moderate Essential Hypertension ◽  
National Committee ◽  
Antihypertensive Medications ◽  
Causative Factors

In worldwide 25% of population is suffering with Hypertension. As it is an instrumental disease, asymptomatic in nature, it was named as Silent killer. The causative factors of Essential hypertension were Genetic predisposition and environmental factors but these factors are triggered by stress hence it comes under stress related psycho-somatic disorder. In Hypertensive patients, Decrease in 5mm of Hg in SBP and DBP results in decrease in cardiovascular risk, stroke which decreases mortality rate worldwide. The management aspect of modern medical science remains symptomatic with troublesome side effects. The Joint National Committee (JNC 8) guideline advise higher blood pressure goals, less use of several types of antihypertensive medications and suggests lifestyle modification and relaxation are the best initial therapy. In Ayurveda, Shirodhara is one of the panchakarma therapy meant for relaxation and stress reducing procedure mentioned in Dharakalpaas a preventive and curative treatment for many stress related disorders. So, Present study is planned as “A Comparative clinical evaluation of Shirodhara with Sukhos̩n̩ajala, Tila tailam and Brahmitailamin the management of mild to moderate essential hypertension”was selected. This paper is going to describe about conclusion drawn from the study i.e. effect of three types of dhara on Objective parameters SBP, DBP, PP, and MAP.

scholarly journals Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

Hypertension ◽  
2003 ◽  
Vol 42 (6) ◽  
pp. 1206-1252 ◽  
Author(s):  
Aram V. Chobanian ◽  
George L. Bakris ◽  
Henry R. Black ◽  
William C. Cushman ◽  
Lee A. Green ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Joint National Committee ◽  
National Committee ◽  
Seventh Report ◽  
Detection Evaluation

scholarly journals ANTIHYPERTENSIVE PHARMACOTHERAPY IN HYPERTENSIVE PATIENTS AT A TERTIARY CARE TEACHING HOSPITAL AND MEDICAL COLLEGE IN INDIA

2021 ◽  
pp. 30-36
Author(s):  
RANJODH JEET SINGH
Keyword(s):  
Heart Rate ◽  
Tertiary Care ◽  
General Medicine ◽  
Olmesartan Medoxomil ◽  
Joint National Committee ◽  
National Committee ◽  
Total Period ◽  
Medical College ◽  
Group B ◽  
Stage 1

Aim and Objectives: The aim of the study was to compare the efficacy of Atenolol and Olmesartan in Stage-1 hypertension (HTN), and the adverse effect profile of Atenolol and Olmesartan in Stage-1 HTN. Methods: A prospective, randomized, open, and parallel study was carried out in 100 patients attending the outpatient department of General Medicine Department MMIMSR, Mullana, Ambala, India with Stage -1 HTN according to joint national committee VII. The patients were randomly divided into two groups to receive Tab. Atenolol 50 mg od (Group A, n=50) and Tab. Olmesartan medoxomil 20 mg (Group B, n=50) od for a total period of 12 weeks with regular follow up every 2 weeks from the baseline. At each visit, blood pressure (BP), heart rate, and adverse effects were evaluated. Laboratory investigations were carried out at baseline and end of the study period. p<0.005 was considered statistically significant. Results: Atenolol and Olmesartan medoxomil both significantly reduce BP and heart rate (p<0.005). Olmesartan medoxomil is more efficacious in reducing BP. Conclusion: Olmesartan medoxomil is a better choice for Stage -1 HTN between the two drugs as it leads to a greater decrement in BP.

Abstract P297: Comparing Blood Pressure Control in Diabetic verses Non-Diabetic Veterans following Percutaneous Coronary Intervention (PCI)

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Sloane A McGraw ◽  
Michael Scholfield ◽  
Ragu Murthy ◽  
Anupama Shivaraju ◽  
Burhan Mohamedali ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Beta Blockers ◽  
Coronary Intervention ◽  
Pressure Control ◽  
Joint National Committee ◽  
National Committee ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
The Mean ◽  
Artery Disease

Background: Blood pressure (BP) control in patients with coronary artery disease (CAD) is beneficial on morbidity and mortality, however the US Joint National Committee VII (JNC-7) also recommends systolic BP (SBP) <130 and diastolic BP (DBP) <80 for diabetic patients because diabetes itself is an additional risk for a cardiac event. This can be attained using beta-blockers (BB), angiotensin agonists (ACE-I/ARB), calcium channel blockers, diuretics and nitrates. Methods: We conducted a retrospective cohort study focusing on attaining JNC-7 guidelines, comparing outcomes between 302 diabetic to the 469 non-diabetic patients; all underwent PCI between September 2004 and September 2008 at the Jesse Brown Veterans Hospital in Chicago, IL. We collected data of BP values and antihypertensive regimens on admission and at six month follow up, and correlated these into percentages of which have attained goals. Results: Among diabetics, mean SBP decreased from 134 to 130mmHg (p = 0.002) and mean DBP decreased from 72 to 70mmHg (p= 0.004); in the non-diabetics, the mean SBP decreased from 133 to 127mmHg (p<0.0001) and the mean DBP decreased from 73 to 71mmHg (p<0.0012). With regards to guidelines, the percent of diabetics at SBP goal increased from 41% to 51% (124 to 154 of 302) (p= 0.006), however the percent at DBP goal was not significant. In non-diabetics, percent at goal for SBP increased 46% to 57% (216 to 267 of 469) (p=0.0002) and for DBP increased 69% to 76% (324 to 356 of 469) (p=0.0131). At 6 months, among diabetics the medication usage increased with BB, 80% to 92% (241 to 278 of 302) (p<0.0001) and nitrates 30% to 36% (91 to 109 of 302) (p=0.035). Similarly, among non-diabetics, use of BB, 68% to 87% (319 to 408 of 469) (p<0.0001) and nitrates 19% to 24% (89 to 113 of 469) (p=0.006) increased, as well as ACE-I/ARB 52% to 71% (244 to 333 if 469) (p<0.0001). Conclusions: There were improvements in BP among both populations at six months post-PCI; both attained JNC-7 SBP goal, but only non-diabetics achieved DBP goal. Medication use increased for both groups with BB and nitrates, but also with ACE-I/ARB for non-diabetics only. This analysis suggests that tighter control needs to be obtained among diabetics, especially because they are a higher risk population than those solely with CAD.

scholarly journals Blood Pressure Screening, Control, and Treatment for Patients With Developmental Disabilities in General Medicine Practices

2016 ◽  
Vol 32 (6) ◽  
pp. 234-239 ◽  
Author(s):  
Steven R. Erickson ◽  
Kayla Kornexl
Keyword(s):  
Blood Pressure ◽  
Developmental Disabilities ◽  
Group Versus ◽  
General Medicine ◽  
Antihypertensive Medications ◽  
Group Outcomes ◽  
History Of ◽  
Special Patient Population ◽  
Primary Care Practices ◽  
And Control

Background: Little is known about the adequacy of screening for and treatment of hypertension for people with developmental disabilities (DD). Pharmacists may assist in identifying and treating this special patient population. Objective: To characterize and compare the screening, treatment, and control of blood pressure (BP) in patients with DD to patients without DD. Methods: This retrospective study identified adult patients of primary care practices within a large academic health system who had DD (DD group) and a comparator group without DD (GenMed group). Outcomes assessed included percentage of patients screened, mean BP, percentage of patients with controlled BP, and antihypertensive medications prescribed. Results: The DD (n = 183) and GenMed groups (n = 497) were nearly all screened for BP. Mean systolic BP was significantly lower in the DD group (119.9 ± 14.6 mm Hg vs 122.8 ± 15.4 mm Hg GenMed, P = .03), while diastolic BP was no different ( P = .7). Stroke was documented significantly more often in the DD group (5.5% vs 1.4%, P = .005). Of patients with uncontrolled BP, the DD group had significantly higher systolic BP (155.8 ± 14.1 mm Hg vs 147.4 ± 9.5 mm Hg GenMed, P = .02). Hypertension was documented in 32% of DD group versus 38.5% of GenMed group, P = .15. Of this group, 88.1% of the DD group had controlled BP versus 78.0% of the GenMed group, P = .09. Antihypertensive prescribing was not different between the groups. Conclusion: DD group patients had similar outcomes for hypertension therapy compared to patients without DD. Those with uncontrolled BP in the DD group tended to have higher systolic BP. Significantly more DD patients had a history of stroke.

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