scholarly journals High Blood Pressure Is Associated with Tubulointerstitial Damage along with Glomerular Damage in Glomerulonephritis. A large Cohort Study

2020 ◽  
Vol 9 (6) ◽  
pp. 1656
Author(s):  
Claudio Bazzi ◽  
Teresa M Seccia ◽  
Pietro Napodano ◽  
Cristina Campi ◽  
Brasilina Caroccia ◽  
...  

The key role of arterial hypertension in chonic kidney disease (CKD) progression is widely recognized, but its contribution to tubulointerstitial damage (TID) in glomerulonephritis (GN) remains uncertain. Hence, the objective of this study is to clarify whether TID is associated with glomerular damage, and whether the damage at the tubulointerstitial compartment is more severe in hypertensive patients. The study included retrospectively consecutive patients referred to the Nephrology Unit with diagnoses of primary glomerulonephritis, lupus nephritis (LN), and nephroangiosclerosis (NAS) at biopsy. At least six glomeruli per biopsy were analysed through light and immunofluorescence microscopy. Global glomerulosclerosis (GGS%), TID, and arteriolar hyalinosis (AH) were used as markers of CKD severity. Of the 448 patients of the cohort, 403 received a diagnosis of GN, with the remaining being diagnosed with NAS. Hypertension was found in 52% of the overall patients, with no significant differences among those with GN, and reaching 88.9% prevalence rate in NAS. The hypertensive patients with GN had more marked damage in glomerular and tubular compartments than normotensives independently of the amount of proteinuria. Moreover, hypertension and GGS% were found to be strongly associated with TID in GN. In GN patients, not only the severity of glomerular damage but also the extent of TID was associated with high blood pressure.

Author(s):  
JÚLIO EDUARDO PEREIRA DE SOUZA ◽  
EMERSON SILVA ◽  
NEIL FERREIRA NOVO ◽  
MARINA TIEMI SHIO

Objective: The aim of this study was to evaluate the influence of pharmaceutical care on the control of high blood pressure (BP) in hypertensive patients. Methods: The study included thirty hypertensive patients from primary or secondary healthcare located in the south of São Paulo, Brazil. Results: The majority of patients was aged over 60 years (68.75%), non-smokers (90%), non-alcoholics (93.33%), did not practice physical activities (93.33%), and presented comorbidities and polypharmacy. The most common drug-related problems were drug-drug interactions, missed doses, incorrect frequency or time of administration, incorrect patient administration technique, and self-medication. The interventions used during the pharmaceutical consultations (PC) were based on the organization of medicines with tools such as a pillbox organizer (84.38%). A significant improvement in BP control (p<0.05) was observed when comparing BP measurements before and after the PC; however, the number of PCs did not influence the BP reduction. Conclusion: Patient guidance and a simple intervention favor better patient understanding of medication administration schedules.


2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Saiful Nurhidayat

Abstract : Hypertension or high blood pressure is an abnormal increase in blood pressure in the arteries continuously over a period. The dangers of hypertension can lead to damage to various organs including kidneys, brain, heart, eye, causing vascular resistance and stroke. Hypertension takes care of the old and continuously. One effective way to lower blood pressure is to obediently take medicine so that it takes the role of families in monitoring patients taking the medication. With the participation of the family are expected to hypertension sufferers can be controlled. This study aims to determine the family's role in monitoring the adherence of hypertensive patients. The study was conducted in rural communities Slahung Ponorogo, a representative sample of 53 respondents taken by purposive sampling. Quantitative design with cross sectional design of the study the family's role in monitoring the adherence of hypertensive patients. Instruments in this study using questionnaires and observation sheets. The results of 53 respondents obtained the majority of the 29 respondents (55%) has the role of both families and 24 respondents (45%) families have a bad role in monitoring medication adherence. Age and education contribute to determining the role family. Intermediate (41-60 years old) and college education contribute to determining the role well. Conversely > 61 years of elementary education and contribute in a bad role.Keywords : the role of the family, medication adherence, hypertension. Abstrak : Hipertensi atau tekanan darah tinggi adalah suatu peningkatan abnormal tekanan darah dalam pembuluh darah arteri secara terus-menerus lebih dari suatu periode. Bahaya hipertensi dapat memicu rusaknya berbagai organ tubuh diantaranya: ginjal, otak, jantung, mata, menyebabkan resistensi pembuluh darah dan stroke. Penyakit hipertensi membutuhkan perawatan yang lama dan terus menerus. Salah satu cara yang efektif untuk menurunkan tekanan darah adalah dengan patuh minum obat sehingga dibutuhkan peran keluarga dalam memantau minum obat penderita. Dengan adanya peran serta keluarga diharapkan penyakit hipertensi penderita dapat terkontrol. Penelitian ini bertujuan untuk mengetahui peran keluarga dalam memantau kepatuhan minum obat penderita hipertensi. Penelitian dilakukan pada masyarakat desa Slahung Ponorogo,sampel representatif sejumlah 53 responden diambil secara Purposive Sampling. Desain kuantitatif dengan rancangan Cross sectional yang mempelajari peran keluarga dalam memantau kepatuhan minum obat penderita hipertensi. Instrumen pada penelitian ini menggunakan kuesioner dan lembar observasi. Hasil penelitian dari 53 responden didapatkan sebagian besar 29 responden (55 %) keluarga mempunyai peran baik dan 24 responden (45 %) keluarga mempunyai peran buruk dalam memantau kepatuhan minum obat. Faktor usia dan pendidikan berkontribusi dalam menentukan peran keluarga. Usia madya (41-60 tahun) dan jenjang pendidikan perguruan tinggi berkontribusi dalam menentukan peran baik. Sebaliknya > 61 tahun dan jenjang pendidikan SD berkontribusi dalam peran buruk.Kata Kunci : peran keluarga, kepatuhan minum obat, penyakit hipertensi.


2017 ◽  
Vol 63 (12) ◽  
pp. 1055-1060 ◽  
Author(s):  
Marcelo Rodrigues Bacci ◽  
Jonathan Naim Mora Emboz ◽  
Beatriz da Costa Aguiar Alves ◽  
Glaucia Luciano da Veiga ◽  
Neif Murad ◽  
...  

Summary Introduction: Obstructive sleep apnea and hypopnea syndrome (OSAHS) is one of the developmental factors of high blood pressure (HBP), a relevant global public health problem. OSAHS is characterized by the reduction or complete cessation of respiratory airflow due to intermittent airway collapse. Additionally, significant changes in sleep rhythm and pattern are observed in these patients. Objective: To evaluate the association between OSAHS and sleep quality in essential and resistant hypertensives. Method: A cross-sectional, observational study evaluated 43 hypertensive patients treated at the outpatient clinics of the Faculdade de Medicina do ABC (FMABC) who were medicated with two or more antihypertensive drugs and divided into nonresistant or resistant to treatment. Results: Group I (using up to two antihypertensive agents – 60.47% of the sample) presented mean systolic blood pressure (SBP) of 127.5±6.4 mmHg, mean diastolic blood pressure (DBP) of 79.6±5.2 mmHg, mean body mass index (BMI) of 27.2±5.3 kg/m2 and mean age of 51.2±15.1 years. Group II (using more than two antihypertensive drugs – 37.2% of the sample) presented mean SBP of 132.1±9.3 mmHg, mean DBP of 84.5±5.8 mmHg, mean BMI of 27.2±7.2 kg/m2 and mean age of 55.5±13.4 years. The patients presented low quality of sleep/sleep disorder evaluated by the Pittsburgh Sleep Quality Index (PSQI), which represents a preponderant factor for OSAHS. Conclusion: Patients at high risk for OSAHS had poor sleep quality and high levels of DBP, suggesting a causal relation between these parameters. However, they did not present a higher prevalence of resistant high blood pressure (RHBP).


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Olivia Y Hung ◽  
Nora L Keenan ◽  
Jing Fang

Introduction: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII) recommended lifestyle interventions, either with or without pharmacologic treatment, for all patients with high blood pressure. The objective of this study is to determine the association of physicians’ personal habits with their attitudes and behaviors regarding JNC VII lifestyle modification guidelines. Hypothesis: Primary care physicians who have healthier habits, as defined by eating more cups of fruits and/or vegetables, exercising more frequently, and/or not smoking, would be more likely to recommend lifestyle interventions consistent with JNC VII than their counterparts who have less healthy habits. Methods: One thousand primary care physicians completed DocStyles 2010, a voluntary web-based survey designed to provide insight into physician attitudes and behaviors regarding various health issues. Results: The respondents’ average age was 45.3 years and 68.5% (685 of 1000) were male. In regards to physician behavior, 4.0% (40 of 1000) smoked at least once a week, 38.6% (386 of 1000) ate ≥5 cups of fruits and/or vegetables ≥5 days/week, and 27.4% (274 of 1000) exercised ≥5 days/week. When asked about specific types of advice offered to their hypertensive patients, physicians reported recommending that their patients eat a healthy diet (922 of 1000), or cut down on salt (961 of 1000), or attain or maintain a healthy weight (948 of 1000), or limit the use of alcohol (754 of 1000), or be physically active (944 of 1000). Collectively, 66.5% (665 of 1000) made all 5 lifestyle modification recommendations. Physicians who were between 40 - 49 years old were 1.6 times as likely of making all 5 lifestyle recommendations compared with those who were under 40 years. Additionally, those who exercised at least once per week or did not actively smoke were approximately twice as likely to recommend these interventions. Conclusions: The probability of recommending all five lifestyle modifications increased with both the physician exercising at least once per week and not having smoked.


Author(s):  
Iraj Zareban ◽  
Marzieh Araban ◽  
Mohammad Reza Rohani ◽  
Mahmood Karimy ◽  
Fereshteh Zamani-Alavijeh ◽  
...  

Physiology ◽  
1991 ◽  
Vol 6 (4) ◽  
pp. 174-177
Author(s):  
R Di Nicolantonio ◽  
T Imai ◽  
K Murakami ◽  
Y Yamori

Nearly one in five adults in acculturated societies has abnormally high blood pressure. Newly emerging techniques in molecular biology offer the possibility of not only determining the role of genetic factors in its etiology but also identifying early predisposed individuals. A more targeted drug treatment may also follow.


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