Indian heart journal最新文献

{"title":"Gender bias in acute myocardial infarction care in India: Nationwide retrospective study of 41832 patients.","authors":"Mrinal Kanti Das, Amit Malviya, Geevar Zachariah, Sivasubramanian Ramakrishnan, Abdullakutty Jabir, Venugopal Krishnan Nair, Neil Bardoloi, Dhurjati Prasad Sinha, Partho Sartha Banrjee, S Shanmugasundaram, Gurpreet Singh Wander, Dhiman Kahali, Debabrata Roy, Rakesh Yadav","doi":"10.1016/j.ihj.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.01.001","url":null,"abstract":"<p><strong>Background: </strong>Various studies have documented gender differences in the management and outcomes of acute myocardial infarction (AMI) in developed countries. Gender differences in the management of AMI in India is not known.</p><p><strong>Objectives: </strong>To document the gender differences in the management and outcomes of AMI in India.</p><p><strong>Methods: </strong>The current study was a nationwide retrospective, multicenter, cross-sectional study including all consecutive AMI patients admitted from 15th March to 15th June in the year 2020 using a historical control of all cases of AMI admitted during the corresponding period in the year 2019.</p><p><strong>Results: </strong>There were only 9018 females (21.6 %) among the 41832 patients with AMI in the study. Females were older and were more likely to present with non ST-elevation MI than men (41.6 % vs. 33.2 %). Significantly fewer number of females underwent primary percutaneous coronary intervention (29.5 % vs 31.2 % p value < 0.001), thrombolysis (32.9 % vs 34.7 %, p value < 0.001), pharmaco-invasive therapy (18.6 % vs 20.7 % p value 0.001). Females had higher in-hospital mortality (7.07%vs 4.07 %, p < 0.001), length of hospital stay (3.9 ± 2.98 days vs 3.8 ± 2.88 days, p < 0.001) and complications of AMI [cardiogenic shock (8.6 % vs 6.3 %), mechanical complications (4.6 % vs 3.8 %), heart failure (13.9%vs 11.7 %) and malignant arrhythmias (3.4%vs2.8 %)] than males.</p><p><strong>Conclusions: </strong>Differences between gender in the presentation, management, and outcomes of acute MI are prevalent in India. Women with acute MI presented at older age, had higher in-hospital mortality and complications, and received revascularization therapy less often compared to men.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive role of CHA₂DS₂-VASc score in acute coronary syndrome patients and value of adding global longitudinal strain to CHA₂DS₂-VASc score.","authors":"Hager Allam, Shaimaa Mostafa, El-Sayed Abd Khalek, Sara Abdalla","doi":"10.1016/j.ihj.2024.12.001","DOIUrl":"10.1016/j.ihj.2024.12.001","url":null,"abstract":"<p><strong>Background: </strong>Future clinical management would be improved by accurate and early identification of ACS patients at high CV risk. In non-valvular atrial fibrillation patients, the prognostic risk of thromboembolism has been evaluated using CHA₂DS₂-VASc scores. It has recently been shown to assess the severity of CAD and foresee patient outcomes. Also, LV global longitudinal strain is an independent predictor of outcome. Our study aimed to determine the added value of LV longitudinal strain (GLS) to CHA₂DS₂-VASc in predicting the outcome and severity of CAD in patients with acute coronary syndrome (ACS).</p><p><strong>Methods: </strong>A total of 577 patients with primary diagnosis of ACS were included between January and July 2021. All patients had evaluations based on history, clinical examination, 12-lead ECG, TTE, and coronary angiography. Six months follow-up had been provided to all patients.</p><p><strong>Results: </strong>Syntax score was significantly higher among patients with high-risk CHA₂DS₂-VASc score (30.5 ± 6.1 vs. 17.34 ± 8.7 vs. 11.11 ± 8.2), p-value <0. 001. GLS was significantly lower among high SYNTAX score (-10.97 ± 2.68 vs. -12.61 ± 3.46 vs. -17.81 ± 2.89), p-value = 0.0001. There was a significant negative correlation between the CHA₂DS₂-VASc score and GLS. Moreover, adding GLS to CHA₂DS₂-VASc score significantly improved overall accuracy for the prediction of outcome and severity of CAD in ACS patients.</p><p><strong>Conclusions: </strong>CHA₂DS₂-VASc score is an easy and simple parameter that can be used in predicting the severity of CAD & adverse clinical outcome in ACS patients and adding GLS to the CHA₂DS₂-VASc score significantly improved overall accuracy.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANTI-THROMBOTIC STRATEGY FOR THE MANAGEMENT OF NONOCCLUSIVE THROMBUS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN YOUNG PATIENTS - ANTARTICA STUDY.","authors":"Pankaj Jariwala, Arshad Punjani, Harikishan Boorugu, Dilip Gude, Anusha Jariwala","doi":"10.1016/j.ihj.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.ihj.2024.12.003","url":null,"abstract":"<p><strong>Introduction: </strong>Various cardiovascular thrombo-embolic clinical entities use combined ATS for prevention and treatment. After PCI, AF patients are typically prescribed DOAC, DAPT/SAPT, as component of ATS to minimize stroke risk and treat pulmonary embolism and venous thromboembolism. Some small observational studies have shown that a combined ATS can clear small thrombi in LV dysfunction and/or apical aneurysms. Therefore, we present a practical, cost-effective, and proof-of-concept ATS for non-occlusive significant coronary thrombus in young, clinically stable STEMI patients based on the aforementioned experiences.</p><p><strong>Methods: </strong>We retrospectively reviewed 145 stable STEMI cases with nonocclusive thrombus and thrombolysis in myocardial infarction flow 2/3 who received dabigatran and clopidogrel (ATS arm). They were compared to 147 comparable patients who received standard-of-care PCI (Control arm). At presentation and 6-months after ATS, NYHA functional class and LVEF were measured in all subjects. All the patients in the ATS arm underwent CT-CAG at 6-months. We examined significant safety outcomes like hemorrhage, reinfarction, and cardiac mortality.</p><p><strong>Results: </strong>The primary angiographic outcome demonstrated complete resolution of the thrombus in all the cases of ATS arm. In the ATS arm, the clinical secondary outcome showed a greater improvement in NYHA class, from 3.53 to 1.07, compared to the control group's 3.6 to 1.49 (p=0.013). Also, the secondary echocardiographic outcome demonstrated a significant improvement in LVEF from a mean of 45.1% to 49.2% in the ATS arm vs. 44.0% to 44.9% in the control arm (p< 0.001). Clinical safety indicated TIMI bleeding and reinfarction reductions. There was no mortality in either arm.</p><p><strong>Conclusion: </strong>Delaying PCI and treating STEMI patients with antithrombotic drugs reduced no-reflow, distal embolization, and intraprocedural thrombotic events. The medical intervention improved myocardial preservation alone.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Coronary Intervention (PCI) in Patients of Rheumatoid Arthritis(RA): A Systematic Review and Meta-Analysis.","authors":"Shobhit Piplani, Anastas Kostojchin, Steve Kong, Aakanksha Sharma, Donclair Brown, Vladimir Jelic, Salil Chaturvedi, Vishal Reddy, Katherine Chang Pieri, Ezekiel Akpan, Tamara Simpson, Wenzhen Xiao, Minas Sakellakis, Aayushi Sharma, Priyanshu Jain, Miroslav Radulovic","doi":"10.1016/j.ihj.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.ihj.2024.12.002","url":null,"abstract":"<p><strong>Aim: </strong>The present study aims to investigate the outcomes of Percutaneous coronary intervention (PCI) in patients with Rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>A systemic search was conducted from electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from inception to 15^th September 2023. All statistical analyses were conducted using Review Manager 5.4.1. Studies meeting inclusion criteria were selected. A random-effect model was used when heterogeneity was seen to pool the studies, and the result was reported in the odds ratio (OR) and the corresponding 95% confidence interval (CI).</p><p><strong>Results: </strong>Eight observational studies were selected to conduct the analysis. A statistically significant increase in major adverse cardiovascular event (MACE) was seen in RA patients after undergoing PCI as compared to the control group (OR = 1.18 (1.16, 1.21); p < 0.00001; I2 = 0%). There was no significant difference found in the long-term revascularization outcome between the RA and non-RA patients (OR = 1.18 (0.81, 1.71); p = 0.39; I2 = 93%). Survival rates of all-cause mortality in the long-term outcome were statistically insignificant among the two groups (OR = 1.21 (0.84, 1.74); p = 0.31; I2 = 99%).</p><p><strong>Conclusion: </strong>Percutaneous coronary intervention is an important intervention to reduce morbidity and mortality but special precautions and attention should be made when it comes to patients with RA. Different precautions such as close monitoring for medication interaction, and tailored post-procedural care are essential in reducing morbidity and mortality.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile and immediate outcomes of balloon mitral valvotomy in low gradient rheumatic mitral stenosis.","authors":"Amit Malviya, Animesh Mishra, Manish Kapoor, Vanlalmalsawmdawngliana Fanai, Vineet Kumar Kamal","doi":"10.1016/j.ihj.2024.11.333","DOIUrl":"10.1016/j.ihj.2024.11.333","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to assess the clinical, hemodynamic characteristics and immediate outcomes of Percutaneous Balloon Mitral Valvotomy (PBMV) in low gradient severe rheumatic mitral stenosis (LGMS) with normal cardiac index.</p><p><strong>Background: </strong>The optimal management of LGMS remains incompletely understood.</p><p><strong>Methods: </strong>We examined 200 consecutive patients with severe rheumatic mitral stenosis (MS) who underwent PBMV between January 2014 and March 2020.</p><p><strong>Results: </strong>Of the 149 patients (who satisfied inclusion criteria), 51 (34.2 %) had LGMS. The mean diastolic pressure gradient (DPG) was 8.70 ± 1.34 mm of Hg in LGMS as compared to 16.2 ± 4.3 mm of Hg in HGMS (p < 0.001). Patients of LGMS were older (39.5 ± 9.7 vs.34.9 ± 11.0 years, p = 0.012), had lower baseline heart rate (76.8 ± 9.5 vs 81.9 ± 12.5, p = 0.010), higher Mitral valve area (MVA) (1.16 ± 0.19 vs 0.99 ± 0.21 cm²,p < 0.001),higher Wilkins score (5.8 ± 1.7 vs 4.9 ± 1.5, p = 0.002) and elevated left ventricular end diastolic pressure (LVEDP) (9.2 ± 2.8 vs 5.8 ± 1.2 mm of Hg,p=<0.001) but lower Pulmonary artery systolic pressure (PASP) (53.1 ± 14.5 vs 62.6 ± 17.8 mm of Hg, p = 0.001) and left atrial (LA) pressure (18.0 ± 3.1vs 22.0 ± 4.4 mm of Hg,p=<0.001). Although, the procedural success rate of PBMV was comparable between LGMS and HGMS (92.2 % vs 96.9 % p = 0.231) but increment in MVA and fall in DPG were significantly higher in HGMS in comparison to LGMS (p-value<0.05).</p><p><strong>Conclusions: </strong>Significant MS may have \"low\" gradients during catheterization and yet be symptomatic, and thus low gradients cannot be alone used as a marker of disease severity. LGMS with normal CI is characterized by unique clinical and hemodynamic features. The immediate outcome of PBMV is comparable to HGMS but the hemodynamic parameters to monitor the success of PBMV are significantly different.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":"408-413"},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertonic saline in acute decompensated heart failure (HSHF).","authors":"Shweta Agrawal, Sunil Abhishek Batta, Tarun Rao, Sumithra Selvam","doi":"10.1016/j.ihj.2024.11.246","DOIUrl":"10.1016/j.ihj.2024.11.246","url":null,"abstract":"<p><p>Hypertonic saline with high dose furosemide improves refractory heart failure. In this case series of 10 patients of refractory acute decompensated heart failure, effect of HSS with furosemide was compared with furosemide alone. Patients responded to the therapy better, with faster decongestion, without significant adverse effects or worsening renal function. Hence an adequately powered, randomized study is required to assess the veracity of findings in this case series of hypertonic saline in diuretic resistant acute decompensated heart failure on optimal therapy. Based on present study, hypertonic saline looks like a promising option in the management of refractory heart failure.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":"418-420"},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of infective endocarditis in patients with hypertrophic cardiomyopathy.","authors":"Somyata Somendra, Saurabh Mehrotra, Parag Barwad, Himanshu Gupta, Ajay Bahl","doi":"10.1016/j.ihj.2024.11.332","DOIUrl":"10.1016/j.ihj.2024.11.332","url":null,"abstract":"<p><strong>Background: </strong>Data on the incidence of infective endocarditis (IE) in patients with hypertrophic cardiomyopathy (HCM) is sparse. This study evaluated a HCM cohort with aim to study the incidence of IE in these patients.</p><p><strong>Methods: </strong>All patients entering the HCM cohort from May 2003 to June 2022 of a tertiary care hospital with at least one follow-up visit were included and followed up till June 2023. This was a retrospective cohort analysis. Only individuals who were diagnosed with IE after entry into the cohort were included.</p><p><strong>Results: </strong>The study cohort consisted of 529 HCM patients with a total follow up duration of 3244.6 years. The mean and median follow-up durations were 6.1 ± 4.7 and 5.3 (range 31 days to 20.1) years respectively. Three (0.57 %) patients in the cohort developed IE. Incidence of IE in HCM patients was 0.92/1000 patient years. Two patients had left ventricular outflow tract obstruction while one had non-obstructive HCM. None of the patients with isolated mid-cavity gradients developed IE. The incidence of IE in the obstructive and nonobstructive groups was 1.39 and 0.55 per 1000 patient years respectively. Two had vegetations on mitral valve while one had vegetations on aortic valve. Both patients with mitral valve endocarditis developed severe residual mitral regurgitation and heart failure.</p><p><strong>Conclusions: </strong>IE is a rare complication in HCM patients with an incidence of 0.92/1000 patient years. However, when it occurs, IE is associated with high morbidity and mortality.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":"405-407"},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influenza vaccine in cardiovascular disease: Current evidence and practice in India.","authors":"Ambuj Roy, Satyavir Yadav","doi":"10.1016/j.ihj.2024.11.247","DOIUrl":"10.1016/j.ihj.2024.11.247","url":null,"abstract":"<p><p>Influenza is a common trigger for cardiovascular events. Temporal association studies of influenza and cardiovascular events have well documented this phenomenon. More recently, randomised clinical trials of influenza vaccine have shown the benefit of immunisation in reducing recurrent cardiovascular events, especially in patients with acute coronary syndrome. Despite this overwhelming benefit, its uptake in India is very low. This could be due to a lack of awareness and paucity of evidence of its benefit in tropical countries like India, where the influenza season is variable and spread throughout the year. In this review, we explore these aspects of influenza and cardiovascular diseases and discuss the way ahead.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":"365-369"},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National experience of alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy: A long-term multicenter retrospective study.","authors":"Evgenii Shloido, Kirill Popov, Sergey Chernyshov, Maksim Kashtanov","doi":"10.1016/j.ihj.2024.11.248","DOIUrl":"10.1016/j.ihj.2024.11.248","url":null,"abstract":"<p><strong>Objectives: </strong>Hypertrophic cardiomyopathy (HCM) is a widespread disease with an incidence of 1:200 in the general population and its surgical and interventional treatment is well-developed in western countries. This study is focusing on outcomes of HCM patients after alcohol septal ablation in Russian Federation.</p><p><strong>Methods: </strong>We conducted a multicenter registry to evaluate outcomes of obstructive hypertrophic cardiomyopathy (oHCM) patients after ASA. Our study was focused on the following outcomes: (i) 30-day mortality, (ii) 30-day permanent pacemaker implantations, (iii) a residual obstruction occurrence, (iv) final maximal left ventricular outflow tract gradient, (v) long-term mortality, (vi) final heart failure functional class, (vii) freedom from sudden cardiac death. We conducted secondary analysis to assess outcomes in patients with single versus repeated ASA. The mean follow-up was 71 ± 47 months.</p><p><strong>Results: </strong>A total of 597 consecutive patients (54.9 % female) were enrolled in the Russian Alcohol Septal Reduction (RASA) registry from three interventional groups. The mean age was 56 ± 14 years. Thirty-day mortality rate was 0.7 % (4 patients). Permanent pacemakers were implanted in 42 (7 %) cases in 30-days follow-up. The resting LVOT gradient reduced from 64 ± 28 to 20 ± 13 mmHg (p < 0.0001), and the mean NYHA class decreased from 2.3 ± 0.7 to 1.3 ± 0.5 (p < 0.001). Long-term survival rates were as follows: 97.4 (95%CI: 96.2-98.7) %, 93.2 (95%CI: 91.0-95.3) %, 84.9 (95%CI: 80.7-89.4) % at 1-, 5-, 10-year follow-up, respectively. Patients after repeated ASA. had similar long-term survival comparing to those who underwent single ASA (weighted log rank p value = 0.254). Heart failure class in the long-term and final gradient at the last follow-up were not statistically different between groups under study (p > 0.05).</p><p><strong>Conclusions: </strong>In our registry, alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy was safe in the short- and long-term follow-up. Outcomes of patients underwent repeated ASA were non-inferior to those after single ASA.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":"390-397"},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current practices and knowledge of home blood pressure monitoring among people with hypertension: Insights from a Multicentric study from North India.","authors":"Akash Batta, Anusha Singhania, Sarit Sharma, Singal Gautam, Ankur Singla, Harsimran Kalsi, Diksha Mahendru, Samneet Singh, Ishaan Goyal, Hiyanoor Ghosh, Aditya Uppal, Nishma Dhand, Namita Bansal, Anurag Chaudhary, Gurpreet Singh Wander, Sivasubramanian Ramakrishnan, Bishav Mohan","doi":"10.1016/j.ihj.2024.11.249","DOIUrl":"10.1016/j.ihj.2024.11.249","url":null,"abstract":"<p><strong>Objectives: </strong>Hypertension (HTN) management guidelines recommend home blood pressure monitoring (HBPM) as an important tool for BP control. Limited data exists on HBPM epidemiology among people with HTN and their caregivers in the Indian context.</p><p><strong>Methods: </strong>The current study was conducted across three North Indian centres to evaluate the prevalence, training and technique of HBPM among people with HTN and their caregivers. People with diagnosed HTN (>3 months duration) and their caregivers, were screened and their HBPM use was evaluated. HBPM practices were assessed by observing participants measuring BP using a pre-validated, structured 16-point observational checklist. HBPM knowledge was assessed using a 19-point self-administered questionnaire based on the most recent AHA guidelines. Responses were graded and classified based on quartiles.</p><p><strong>Results: </strong>A total of 2750 participants were screened, of which 2588 (2070 from urban and 518 from rural areas) were included. A total of 468 (18.1 %) were using HBPM. The proportion of respondents using HBPM was 20.5 % (424/2070) in urban, and 8.5 % (44/518) in rural areas. Only 24.7 % (n = 116) of the 468 participants (236 patients and 232 caregivers) using HBPM at home recalled ever receiving training from any healthcare workers. The majority (75.2 %, 352/468) of participants reported learning HBPM themselves through observation, videos, and reading. In HBPM practice assessment, 15.9 % of people with HTN (37/232) vs 5.9 % caregivers (14/236) scored excellent (score >75 %). In HPBM knowledge assessment, 0.4 % of people with HTN (1/232) vs no caregivers scored excellent. HPBM practices were better than knowledge, with mean scores of 62.3 ± 13.1 % and 40.1 ± 16.2 % respectively. Higher education level was associated with improved patient knowledge (p = 0.041), but not practices (p = 0.225).</p><p><strong>Conclusions: </strong>There is need for more robust training on HBPM to enable people from all backgrounds to better manage their HTN, especially in rural areas. Education is not a barrier to learning good HBPM technique.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":"398-404"},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}