scholarly journals Community-Based Interventions to Improve the Control of Non-Communicable Diseases in Underserved Rural Areas in Brazil: A Before-and-After Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Jéssica Caline Lemos Macedo ◽  
Vivian Carla Honorato dos Santos de Carvalho ◽  
Taciana Borges Andrade Cortes ◽  
Daniela Arruda Soares ◽  
Sóstenes Mistro ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Rural Communities ◽  
Rural Areas ◽  
Blood Pressure Level ◽  
The Elderly ◽  
Diabetic Patients ◽  
Community Based Interventions ◽  
Life Years ◽  
Before And After ◽  
Patients With Diabetes

Background: Hypertension and diabetes mellitus are the second and third highest leading causes of disability-adjusted life-years (DALY), respectively, in Brazil. The clinical outcomes of chronic diseases are influenced by various factors. Therefore, there is a need for multifaceted interventions to achieve a decrease in the rate of DALY, with a better control of these diseases.Objective: To verify whether sustainable long-term interventions, such as health worker training and provision of health education to the patients, contribute to health improvements in patients with hypertension and diabetes from rural communities.Methods: Over a 6 month period, educational and medical interventions were provided to optimize the treatment of hypertension and diabetes. Furthermore, blood pressure and glycated hemoglobin (HbA1c) measurements were taken at baseline and after the interventions.Results: The monitored hypertensive patients (n = 276) had a reduction of 13.4 mmHg (p = 0.021) and 5.8 mmHg (p < 0.001) in mean systolic and diastolic blood pressure, respectively. Diabetic patients who were followed-up (n = 71) achieved a 0.55% (p = 0.185) reduction in HbA1c level. The desired blood pressure level (<140/90 mmHg) was achieved in 38.8% of patients with hypertension, whereas the desired level of HbA1c (<7.0% for adults and <8.0% for the elderly) was achieved in 16.9% of patients with diabetes; in addition, 38.0% had a reduction of HbA1c of at least 1%.Conclusion: The results showed that the interventions improved the blood pressure and HbA1c levels in patients with hypertension and diabetes from rural communities in a municipality in Northeast Brazil.

Abstract P169: Change In Blood Pressure Level And Its Association With Cardiovascular Events In The Healthy Elderly: Findings From The Aspirin In Reducing Events In The Elderly Trial

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Enayet K Chowdhury ◽  
Michael E Ernst ◽  
Mark R Nelson ◽  
Lawrence J Beilin ◽  
Karen L Margolis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Proportional Hazards ◽  
Blood Pressure Level ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Trial Period ◽  
Cvd Risk ◽  
Healthy Elderly ◽  
Proportional Hazards Regression ◽  
Before And After

Blood pressure (BP) increases with age and is a major risk factor for cardiovascular disease (CVD). We examined change in BP level over a median of 4.7 years in ASPirin in Reducing Events in the Elderly trial participants, and its association with CVD events. Participants with baseline and at least one in-trial BP measurement were included. Since CVD event can affect BP (before and after), participants having a non-fatal CVD event in between in-trial BP records were excluded. Participants were classified according to baseline BP level, irrespective of antihypertensive use, into three groups (A) normal (SBP<130 & DBP<80 mmHg), (B) elevated (SBP 130-139 and/or DBP 80-89) and (C) high (BP≥140/90). Thereafter, based on the average of their in-trial BP level, participants were again classified into three BP categories (i.e. normal /elevated /high). Cox proportional hazards regression was used to examine the association of CVD events with change in BP group in relation to their baseline. 17543 ASPREE participants were included in the analysis. At baseline, 26% had normal, 25% had elevated and 49% had high BP. Participants’ BP status during the trial period and its association with CVD events in relation to baseline BP category are summarized in the Figure. Among those with high BP at baseline, 60% remained with high BP, 28% moved down to elevated BP, and 11% moved to normal BP. Reduced CVD risk was observed among participants who reduced BP to elevated BP category from high BP during the trial period. However, no difference was observed in risk reduction among those achieving normal BP levels from baseline high BP. An increase in BP from normal category demonstrates a two times increase in CVD risk.

Influence of intermittent hypoxia interval training on exercise-dependent erythrocyte NOS activation and blood pressure in diabetic patients

2012 ◽  
Vol 90 (12) ◽  
pp. 1591-1598 ◽  
Author(s):  
Dennis Ladage ◽  
Christian Braunroth ◽  
Edward Lenzen ◽  
Sandra Berghöfer ◽  
Christine Graf ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Physical Exercise ◽  
Intermittent Hypoxia ◽  
Interval Training ◽  
Diabetic Patients ◽  
Before And After ◽  
Patients With Diabetes ◽  
Male Patients ◽  
Exercise Induced

NOS-activation in erythrocytes (eryNOS) is impaired in patients suffering from type 2 diabetes. We investigated the effect of physical exercise on eryNOS activation and whether 6 week hypoxia interval training may alter this process. Male patients with diabetes mellitus type 2 (NIDDM, n = 12; age, 61.3 ± 8.4 years; BMI, 29.8 ± 3.7 kg/m2) underwent physical exercise training before and after 6 week hypoxia interval training. Training was conducted 4 times per week for 90 min at 15.4–12.7 Vol% of inspired oxygen. Vital parameters were recorded. Before hypoxia intervention, eryNOS phosphorylation at serine1177decreased significantly during exercise (basal 17.4 ± 12.0 compared with exercise 8.4 ± 9.2 arbitrary grey values (arGV); P < 0.05). After 6 weeks of hypoxia intervention, eryNOS–pSer1177(2.2 ± 2.5 arGV) was significantly lower at baseline. Ergometry showed an increase (7.6 ± 3.0 arGV; P < 0.05) followed by a decrease to almost baseline levels after 30 min (3.8 ± 1.5 arGV). Maximal exercise capacity and O2-uptake ([Formula: see text]  max) increased significantly. The effects were independent from exercise-induced elevation of blood pressure. Exercise-dependent eryNOS phosphorylation at serine1177was increased similar to that described for the endothelium in diabetic patients. EryNOS dysregulation was partially restored after intermittent hypoxia training.

scholarly journals Prevalence and Control of Hypertension in Iraqi Diabetic Patients: A Prospective Cohort Study

2012 ◽  
Vol 6 (1) ◽  
pp. 68-71 ◽  
Author(s):  
Abbas Ali Mansour
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Odds Ratio ◽  
Blood Pressure Level ◽  
Target Blood Pressure ◽  
Diabetic Patients ◽  
Study Cohort ◽  
Patients With Diabetes

Objectives: Diabetes and hypertension are major risk factors for cardiovascular disease, a leading cause of death in humans. The aim of our study was to determine the prevalence of hypertension, and hypertension control among adults with diabetes in Basrah (Southern Iraq). Methods: A prospective cohort study was conducted at Al-Faiha Diabetes and Endocrine Center in Basrah. It was started in August 2008 to April 2011. The total number of recruited patients with diabetes was 5578. Results: Hypertensive diabetic patients constituted 89.6% of this study cohort, with 45.3% of them newly discovered in the center. From hypertensive patients, 48.2% achieved the target blood pressure of less than 130/80 mmHg. The results of the multivariate analyses showed that the factors independently associated with the hypertension were aged > 50 years (odds ratio, 0.4; 95% CI, 0.3 to 0.5; p < 0.001), body mass index equal or more than 25 (odds ratio, 0.5; 95% CI, 0.4 to 0.6; p < 0.001), insulin use (odds ratio, 0.6; 95% CI, 0.5 to 0.8; p < 0.001) and duration of diabetes > 5 years (odds ratio, 0.6; 95% CI, 0.5 to 0.7; p < 0.001) . Conclusion: This study confirmed that hypertension was seen in ~90% of diabetic patients in Iraq, and approximately half of them were achieving target blood pressure level.

OPTIMIZATION OF ARTERIAL HYPERTENSION TREATMENT IN DIABETIC PATIENTS

2020 ◽  
pp. 37-41
Author(s):  
Андрей Петрович Бабкин
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Therapy ◽  
Blood Pressure Level ◽  
Load Test ◽  
Diabetic Patients ◽  
Table Salt ◽  
Patients With Diabetes ◽  
Baseline Values ◽  
The Individual

Достижение целевого уровня артериального давления у больных сахарным диабетом является такой же важной задачей, как и коррекция метаболических нарушений. Проведен анализ эффективности комбинированной антигипертензивной терапии у больных сахарным диабетом с диабетической нефропатией на основе динамики гемодинамических и метаболических параметров у больных с различной реакцией артериального давления на нагрузку поваренной солью. Выяснено, что больные с данной патологией не одинаково реагируют на нагрузку поваренной солью - у 23 (53,3 %) пациентов выявлено повышение систолического АД на 10 и более мм рт. ст. (солечувствительные пациенты), а у 21 (46,7%) повышение АД было менее 10 мм рт. ст. или отсутствовало (солерезистентные пациенты). Солечувствительные пациенты имели более высокие исходные значения показателей суточного мониторирования АД - САД ср. у солечувствительных пациентов равнялось 157,4 ± 1,0 мм рт. ст. против 150,7 ± 0,8 мм рт. ст. у солерезистентных пациентов, р<0,01. Обе комбинации лекарственных препаратов показали сопоставимый антигипертензивный эффект. Установлено, что у больных, принимавших комбинацию периндоприла и индапамида и вальсартана и индапамида, более выраженный антигипертензивный эффект был отмечен у больных с солечувствительным характером артериальной гипертонии в каждой группе лечения. Определение солечувствительности АД позволяет прогнозировать индивидуальную эффективность антигипертензивной терапии на основе использования теста с нагрузкой поваренной солью Reaching the target blood pressure level in diabetic patients is as important as correcting metabolic disorders. The analysis of the effectiveness of combined antihypertensive therapy in patients with diabetes mellitus with diabetic nephropathy based on the dynamics of hemodynamic and metabolic parameters in patients with different reactions of blood pressure to the load of table salt. It was found that patients with this pathology do not equally respond to the load of table salt - 23 (53.3%) patients showed an increase in systolic blood pressure by 10 mm Hg or more. Art. (salt-sensitive patients), and in 21 (46.7%) the increase in blood pressure was less than 10 mm Hg. Art. or absent (salt-resistant patients. Salt-sensitive patients had higher baseline values of 24-hour BP monitoring - SBP mean in salt-sensitive patients was 157.4 ± 1.0 mm Hg versus 150.7 ± 0.8 mm Hg in salt-resistant patients, p <0.01. Both drug combinations showed a comparable antihypertensive effect. Determination of blood pressure salt sensitivity makes it possible to predict the individual effectiveness of antihypertensive therapy based on the use of a salt load test

PENGARUH TERAPI TERTAWA TERHADAP PENURUNAN TEKANAN DARAH LANSIA DI UPT PANTI WREDHA BUDHI DHARMA YOGYAKARTA

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Niken Setyaningrum ◽  
Andri Setyorini ◽  
Fachruddin Tri Fitrianta
Keyword(s):  
Blood Pressure ◽  
Data Analysis ◽  
The Elderly ◽  
Control Group ◽  
Group Comparison ◽  
Control Blood Pressure ◽  
Men And Women ◽  
Treatment Of Hypertension ◽  
Before And After ◽  
The Difference

ABSTRACTBackground: Hypertension is one of the most common diseases, because this disease is suffered byboth men and women, as well as adults and young people. Treatment of hypertension does not onlyrely on medications from the doctor or regulate diet alone, but it is also important to make our bodyalways relaxed. Laughter can help to control blood pressure by reducing endocrine stress andcreating a relaxed condition to deal with relaxation.Objective: The general objective of the study was to determine the effect of laughter therapy ondecreasing elderly blood pressure in UPT Panti Wredha Budhi Dharma Yogyakarta.Methods: The design used in this study is a pre-experimental design study with one group pre-posttestresearch design where there is no control group (comparison). The population in this study wereelderly aged over> 60 years at 55 UPT Panti Wredha Budhi Dharma Yogyakarta. The method oftaking in this study uses total sampling. The sample in this study were 55 elderly. Data analysis wasused to determine the difference in blood pressure before and after laughing therapy with a ratio datascale that was using Pairs T-TestResult: There is an effect of laughing therapy on blood pressure in the elderly at UPT Panti WredhaBudhi Dharma Yogyakarta marked with a significant value of 0.000 (P <0.05)

High-dose Cholecalciferol Supplementation Reducing Morning Blood Pressure in Normotensive DM1 Patients

2020 ◽  
Vol 16 ◽  
Author(s):  
Natércia Neves Marques de Queiroz ◽  
Franciane Trindade Cunha de Melo ◽  
Fabrício de Souza Resende ◽  
Luísa Corrêa Janaú ◽  
Norberto Jorge Kzan de Souza Neto ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vitamin D ◽  
Blood Pressure Monitoring ◽  
Vitamin D Supplementation ◽  
High Dose ◽  
Before And After ◽  
Patients With Diabetes ◽  
Morning Blood Pressure ◽  
Cholecalciferol Supplementation ◽  
Lipids Profile

Background: Vitamin D (VD) deficiency has been related to several endocrine metabolic and cardiovascular diseases. Effect of VD supplementation on blood pressure (BP) in patients with diabetes is controversial. Objective: The aim of this study was to evaluate high-dose vitamin D supplementation effects on blood pressure of normotensive type 1 diabetes mellitus (T1DM) patients by 24-hour ambulatory blood pressure monitoring (ABPM). Methods: We performed a clinical trial including 35 T1DM normotensive patients, who received doses of 4,000 or 10,000 IU/day of cholecalciferol for 12 weeks according to previous VD levels. They underwent 24-hour ABPM, along with glycated hemoglobin, creatine, lipids profile and PCRus dosage before and after VD supplementation. Results and discussion: We found an expressive reduction of systolic and diastolic morning blood pressures (117±14 vs 112±14, p<0,05; 74±9 vs 70±10 mmHg, p<0,05, respectively) with no changes in other pressoric markers. Besides, we noticed a relation between levels of VD after supplementation and diastolic morning blood pressure (r= -0,4; p<0.05). Conclusion: Our study suggests an association between supplementation of high doses of vitamin D and the reduction of morning blood pressure in normotensive T1DM patients.

scholarly journals A preliminary study on diabetes self-management education and glycemic control among patients with diabetes mellitus

2019 ◽  
Vol 9 (9) ◽  
pp. 98 ◽  
Author(s):  
Kisokanth G. ◽  
Indrakumar J. ◽  
Prathapan S. ◽  
Joseph J. ◽  
Ilankoon I.M.P.S.
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Management Education ◽  
Self Management ◽  
Rank Test ◽  
Diabetic Patients ◽  
Effective Measure ◽  
Before And After ◽  
Patients With Diabetes ◽  
Preliminary Study

This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.

PERBEDAAN PENGETAHUAN DAN SIKAP PASIEN DIABETES MELLITUS RAWAT INAP RUMAH SAKIT ISLAM SAMARINDA SEBELUM DAN SESUDAH KONSELING GIZI DENGAN MENGGUNAKAN MEDIA AUDIOVISUAL

2017 ◽  
Vol 2 (1) ◽  
pp. 8
Author(s):  
Siswanto Siswanto ◽  
Ismail Kamba ◽  
Siti Aminah
Keyword(s):  
Diabetes Mellitus ◽  
Public Health Problem ◽  
Visual Media ◽  
P Value ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Disease Mortality ◽  
Before And After ◽  
Patients With Diabetes

Diabetes mellitus is one of the communicable diseases that have become a public health problem, not only in Indonesia but also the world. Currently morbidity of diabetes mellitus is increasing every year, where in 2006 there were 14 million people in 2011 and ranks fourth with 773 cases. DM is also a cause of disease mortality by 5.8%. And Samarinda own particular Islamic Hospital years 2009, there were 449 patients with DM, and 2011 an increase in the 1931 patients with diabetes mellitus. To increase patients’ knowledge about diabetes and diabetic patients be directing attitudes that support or positive attitude towards keeping blood glucose levels to remain normal. Methode to use pra eksperiment with one group pretest posttest. individual conseling withAudiovisual media. There is increased knowledge about diabetes diabetic patients before and after intervention with increasing value of 3.77 (p value = 0.000) and increase in attitudes regarding diabetes mellitus diabetic patients with an increase in the value of 5,35 (p value = 0.003). There was an increase in knowledge and attitudes of patients hospitalized with diabetes mellitus hospital after islam samarinda given nutritional counseling using audio-visual media

scholarly journals Control of blood pressure and cardiovascular outcomes in type 2 diabetes

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 304-323 ◽  
Author(s):  
Hernando Vargas-Uricoechea ◽  
Manuel Felipe Cáceres-Acosta
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Events ◽  
Angiotensin Receptor Blockers ◽  
Pharmacological Therapy ◽  
Current Evidence ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors ◽  
Patients With Diabetes ◽  
The Impact

AbstractHigh blood pressure in patients with diabetes mellitus results in a significant increase in the risk of cardiovascular events and mortality. The current evidence regarding the impact of intervention on blood pressure levels (in accordance with a specific threshold) is not particularly robust. Blood pressure control is more difficult to achieve in patients with diabetes than in non-diabetic patients, and requires using combination therapy in most patients. Different management guidelines recommend initiating pharmacological therapy with values >140/90 mm/Hg; however, an optimal cut point for this population has not been established. Based on the available evidence, it appears that blood pressure targets will probably have to be lower than <140/90mmHg, and that values approaching 130/80mmHg should be recommended. Initial treatment of hypertension in diabetes should include drug classes demonstrated to reduce cardiovascular events; i.e., angiotensin converting-enzyme inhibitors, angiotensin receptor blockers, diuretics, or dihydropyridine calcium channel blockers. The start of therapy must be individualized in accordance with the patient's baseline characteristics, and factors such as associated comorbidities, race, and age, inter alia.

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