Integrated Blood Pressure Control最新文献

{"title":"Quality improvement project for managing elevated blood pressure in a primary care setting.","authors":"Stephanie M Thomas, Holly B Cassells","doi":"10.2147/IBPC.S137112","DOIUrl":"10.2147/IBPC.S137112","url":null,"abstract":"<p><p>Elevated blood pressure (BP) and prehypertension increase the risk of cardiovascular diseases, a national health concern. This article presents a quality improvement project implemented within a primary care setting that aimed at lowering cardiovascular risk by improving the identification, treatment, and follow-up of patients with elevated BP. This project was designed and implemented to address the identified deficiencies contributing to poor identification and follow-up of patients with elevated BP. The intervention was multi-pronged and comprised a staff educational program, introduction of a new method for measuring BP using the BpTRU™ device, and patient educational intervention. A significant improvement in staff BP knowledge scores was achieved following the intervention (<i>p</i><0.05). Patient participants also exhibited a significant improvement in post-intervention BP measurements (<i>p</i><0.05). This project showed that the implementation of a quality improvement project in a primary care setting can lead to significant improvements in staff BP knowledge and patient BP readings. However, future research in this area is required to determine whether particular lifestyle changes are directly associated with the reduction in BP.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"10 ","pages":"25-32"},"PeriodicalIF":2.2,"publicationDate":"2017-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S137112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35552103","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":"Preeclampsia and cardiovascular disease: interconnected paths that enable detection of the subclinical stages of obstetric and cardiovascular diseases.","authors":"Gloria Valdés","doi":"10.2147/IBPC.S138383","DOIUrl":"https://doi.org/10.2147/IBPC.S138383","url":null,"abstract":"<p><p>The potent and now longstanding evidence of the association between placentation-related disorders and cardiovascular disease should be translated into clinical practice in order to introduce a preventive approach to future obstetric and cardiovascular diseases. The purpose of this review is to integrate cardiovascular risk/disease and obstetric complications, which are linked by endothelial dysfunction, as windows of opportunity for improving women's health. Questionnaires adaptable to local practices are proposed to incorporate cardiovascular and obstetrical indexes into two stages of a woman's lifetime.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"10 ","pages":"17-23"},"PeriodicalIF":2.2,"publicationDate":"2017-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S138383","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35396854","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":"Serum magnesium and calcium in preeclampsia: a comparative study at the Korle-Bu Teaching Hospital, Ghana.","authors":"Ebenezer Owusu Darkwa,&nbsp;Charles Antwi-Boasiako,&nbsp;Robert Djagbletey,&nbsp;Christian Owoo,&nbsp;Samuel Obed,&nbsp;Daniel Sottie","doi":"10.2147/IBPC.S129106","DOIUrl":"https://doi.org/10.2147/IBPC.S129106","url":null,"abstract":"<p><strong>Background: </strong>A large percentage (16% of maternal mortality in developed countries, compared to 9% in developing countries), is due to hypertensive disorders in pregnancy. The etiology of preeclampsia remains unknown, with poorly understood pathophysiology. Magnesium and calcium play an important role in vascular smooth muscle function and therefore a possible role in the development of preeclampsia.</p><p><strong>Aim: </strong>We aimed to compare serum magnesium and total calcium levels of preeclamptic and normal pregnant women at the Korle-Bu Teaching Hospital in Ghana.</p><p><strong>Patients and methods: </strong>A comparative cross-sectional study involving 30 normal pregnant and 30 preeclamptic women with >30 weeks gestation and aged 18-35 years, was conducted at the Korle-Bu Teaching Hospital. Magnesium and calcium were determined using a flame atomic absorption spectrometer.</p><p><strong>Results: </strong>Mean serum magnesium and total calcium levels in preeclamptic women were 0.70±0.15 and 2.13±0.30 mmol/L, respectively. Mean serum magnesium and total calcium levels in normal pregnant women were 0.76±0.14 and 2.13±0.35 mmol/L, respectively. There was a statistically nonsignificant difference in serum magnesium and total calcium in preeclamptic women compared to normal pregnant women, with <i>p</i>-values of 0.092 and 0.972, respectively.</p><p><strong>Conclusion: </strong>Serum magnesium and total calcium, therefore, seem not to differ in preeclamptic women compared to normal pregnant women in Ghana.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"10 ","pages":"9-15"},"PeriodicalIF":2.2,"publicationDate":"2017-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S129106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35364668","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":"Medication adherence and its associated factors among hypertensive patients attending the Debre Tabor General Hospital, northwest Ethiopia.","authors":"Destaw Fetene Teshome, Kindie Bantie Bekele, Yohannes Ayanaw Habitu, Abebaw Addis Gelagay","doi":"10.2147/IBPC.S128914","DOIUrl":"10.2147/IBPC.S128914","url":null,"abstract":"<p><strong>Background: </strong>Medication adherence is an important predictor of optimal blood pressure control; hence, it significantly reduces the risk of cardiovascular disease (CVD) and associated deaths. However, studies on medication adherence and its associated factors are scarce. Thus, this study aimed to assess adherence to antihypertensive medications and identify associated factors at Debre Tabor General Hospital, northwest Ethiopia.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted. Simple random sampling technique was used to select 346 participants. A structured questionnaire adapted from the World Health Organization (WHO) STEPwise approach was used to collect data. Medication adherence was measured by the four-item Morisky-Green-Levine Scale, with a score ≥3 defined as \"good adherence\". Data were entered using Epi Info version 7 and exported to SPSS version 20 for analysis. Descriptive and summary statistics were used. Bivariate and multivariable analyses were also carried out.</p><p><strong>Results: </strong>A total of 337 hypertensive patients participated in the study. Three-quarters (75.1%) of the participants were found to be adherent to their medication therapy. The multivariable logistic regression analysis showed that urban residence (adjusted odd ratio [AOR]=2.10, 95% confidence interval [CI]: 1.15, 3.85), taking less than two drugs per day (AOR=3.04, 95% CI: 1.53, 6.06), and having knowledge about hypertension (HTN) and its treatment (AOR=8.86, 95% CI: 4.67, 16.82) were positively and significantly associated with medication adherence, while age >60 years (AOR=0.33, 95% CI: 0.11, 0.98) was negatively and significantly associated with good medication adherence.</p><p><strong>Conclusion: </strong>A significant proportion of hypertensive patients poorly adhere to antihypertensive medications. Age, residence, pill burden, and knowledge about HTN and its treatment are important predictors of medication adherence. Attention should be given to increase the knowledge of patients about their disease and its treatment, and due emphasis should also be given to older and rural patients.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"10 ","pages":"1-7"},"PeriodicalIF":2.2,"publicationDate":"2017-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/3a/ibpc-10-001.PMC5482403.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35136395","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":"Consumption of nattokinase is associated with reduced blood pressure and von Willebrand factor, a cardiovascular risk marker: results from a randomized, double-blind, placebo-controlled, multicenter North American clinical trial.","authors":"Gitte S Jensen,&nbsp;Miki Lenninger,&nbsp;Michael P Ero,&nbsp;Kathleen F Benson","doi":"10.2147/IBPC.S99553","DOIUrl":"10.2147/IBPC.S99553","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to evaluate the effects of consumption of nattokinase on hypertension in a North American hypertensive population with associated genetic, dietary, and lifestyle factors. This is in extension of, and contrast to, previous studies on Asian populations.</p><p><strong>Materials and methods: </strong>A randomized, double-blind, placebo-controlled, parallel-arm clinical study was performed to evaluate nattokinase (NSK-SD), a fermented soy extract nattō from which vitamin K2 has been removed. Based on the results from previous studies on Asian populations, 79 subjects were enrolled upon screening for elevated blood pressure (BP; systolic BP ≥130 or diastolic BP ≥90 mmHg) who consumed placebo or 100 mg nattokinase/d for the 8-week study duration. Blood collections were performed at baseline and 8 weeks for testing plasma renin activity, von Willebrand factor (vWF), and platelet factor-4. Seventy-four people completed the study with good compliance.</p><p><strong>Results: </strong>Consumption of nattokinase was associated with a reduction in both systolic and diastolic BP. The reduction in systolic BP was seen for both sexes but was more robust in males consuming nattokinase. The average reduction in diastolic BP in the nattokinase group from 87 mmHg to 84 mmHg was statistically significant when compared to that in the group consuming placebo, where the average diastolic BP remained constant at 87 mmHg (<i>P</i><0.05), and reached a high level of significance for males consuming nattokinase, where the average diastolic BP dropped from 86 mmHg to 81 mmHg (<i>P</i><0.006). A decrease in vWF was seen in the female population consuming nattokinase (<i>P</i><0.1). In the subpopulation with low plasma renin activity levels at baseline (<0.29 ng/mL/h), an increase was seen for 66% of the people after 8-week consumption of nattokinase (<i>P</i><0.1), in contrast to only 8% in the placebo group.</p><p><strong>Conclusion: </strong>The data suggest that nattokinase consumption in a North American population is associated with beneficial changes to BP in a hypertensive population, indicating sex-specific mechanisms of action of nattokinase's effect on vWF and hypertension.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"9 1","pages":"95-104"},"PeriodicalIF":2.2,"publicationDate":"2016-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S99553","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68363221","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 best practice in the management of hypertensive disorders in pregnancy.","authors":"Rosemary Townsend,&nbsp;Patrick O'Brien,&nbsp;Asma Khalil","doi":"10.2147/IBPC.S77344","DOIUrl":"https://doi.org/10.2147/IBPC.S77344","url":null,"abstract":"<p><p>Preeclampsia is a potentially serious complication of pregnancy with increasing significance worldwide. Preeclampsia is the cause of 9%-26% of global maternal mortality and a significant proportion of preterm delivery, and maternal and neonatal morbidity. Incidence is increasing in keeping with the increase in obesity, maternal age, and women with medical comorbidities entering pregnancy. Recent developments in the understanding of the pathophysiology of preeclampsia have opened new avenues for prevention, screening, and management of this condition. In addition it is known that preeclampsia is a risk factor for cardiovascular disease in both the mother and the child and presents an opportunity for early preventative measures. New tools for early detection, prevention, and management of preeclampsia have the potential to revolutionize practice in the coming years. This review presents the current best practice in diagnosis and management of preeclampsia and the hypertensive disorders of pregnancy. </p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"9 ","pages":"79-94"},"PeriodicalIF":2.2,"publicationDate":"2016-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S77344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34331108","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":"Lercanidipine/enalapril combination in the management of obesity-related hypertension.","authors":"Guido Grassi","doi":"10.2147/IBPC.S92779","DOIUrl":"https://doi.org/10.2147/IBPC.S92779","url":null,"abstract":"<p><p>Obesity-related hypertension represents a condition frequently observed in current clinical practice characterized by a complex pathophysiological background and a very high cardiovascular risk profile, particularly in severely obese individuals. This explains, on the one hand, the difficulty in reducing elevated blood pressure values in this pathological state and, on the other, the need to achieve this goal in a relatively short-time period to prevent the occurrence of fatal and nonfatal cardiovascular events. Both nonpharmacological and pharmacological measures are available in the therapeutic approach for this condition. Among the pharmacological interventions, a combination of two antihypertensive drugs represents the most common recommended strategy aimed at achieving blood pressure control. This paper, after briefly examining the main pathophysiological features of obesity-related hypertension, will review the importance in the treatment of this condition of the drug combination based on a calcium channel blocker and an angiotensin-converting enzyme inhibitor, with specific focus on lercanidipine/enalapril. Following an analysis of the main pharmacological properties of the combination, the results of the studies based on this pharmacological approach in obesity-related hypertension will be critically discussed. The efficacy, safety, and tolerability profile of the lercanidine/enalapril drug combination as well as its potential limitations will also be examined. </p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"9 ","pages":"69-77"},"PeriodicalIF":2.2,"publicationDate":"2016-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S92779","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34480250","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":"Personalized medicine and treatment approaches in hypertension: current perspectives.","authors":"James Brian Byrd","doi":"10.2147/IBPC.S74320","DOIUrl":"https://doi.org/10.2147/IBPC.S74320","url":null,"abstract":"<p><p>In the US, hypertension affects one in three adults. Current guideline-based treatment of hypertension involves little diagnostic testing. A more personalized approach to the treatment of hypertension might be of use. Several methods of personalized treatment have been proposed and vetted to varying degrees. The purpose of this narrative review is to discuss the rationale for personalized therapy in hypertension, barriers to its development and implementation, some influential examples of proposed personalization measures, and a view of future efforts. </p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"9 ","pages":"59-67"},"PeriodicalIF":2.2,"publicationDate":"2016-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S74320","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34481947","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":"Evaluation and treatment of hypertensive crises in children","authors":"Deborah R. Stein, M. Ferguson","doi":"10.2147/IBPC.S50640","DOIUrl":"https://doi.org/10.2147/IBPC.S50640","url":null,"abstract":"Hypertensive crises in children are medical emergencies that must be identified, evaluated, and treated promptly and appropriately to prevent end-organ injury and even death. Treatment in the acute setting typically includes continuous intravenous antihypertensive medications with monitoring in the intensive care unit setting. Medications commonly used to treat severe hypertension have been poorly studied in children. Dosing guidelines are available, although few pediatric-specific trials have been conducted to facilitate evidence-based therapy. Regardless of what medication is used, blood pressure should be lowered gradually to allow for accommodation of autoregulatory mechanisms and to prevent cerebral ischemia. Determining the underlying cause of the blood pressure elevation may be helpful in guiding therapy.","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"9 1","pages":"49 - 58"},"PeriodicalIF":2.2,"publicationDate":"2016-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S50640","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68363044","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":"Effectiveness of continuous positive airway pressure in lowering blood pressure in patients with obstructive sleep apnea: a critical review of the literature","authors":"Fernanda Fatureto-Borges, G. Lorenzi-Filho, L. Drager","doi":"10.2147/IBPC.S70402","DOIUrl":"https://doi.org/10.2147/IBPC.S70402","url":null,"abstract":"Obstructive sleep apnea (OSA) is an extremely common comorbid condition in patients with hypertension, with a prevalence of ~50%. There is growing evidence suggesting that OSA is a secondary cause of hypertension, associated with both poor blood pressure (BP) control and target organ damage in patients with hypertension. The application of continuous positive airway pressure (CPAP) during sleep is the gold standard treatment of moderate- to-severe OSA and very effective in abolishing obstructive respiratory events. However, several meta-analyses showed that the overall impact of CPAP on BP is modest (~2 mmHg). There are several potential reasons for this disappointing finding, including the heterogeneity of patients studied (normotensive patients, controlled, and uncontrolled patients with hypertension), non-ideal CPAP compliance, clinical presentation (there is some evidence that the positive impact of CPAP on lowering BP is more evident in sleepy patients), and the multifactorial nature of hypertension. In this review, we performed a critical analysis of the literature evaluating the impact of CPAP on BP in several subgroups of patients. We finally discussed perspectives in this important research area, including the urgent need to identify predictors of BP response to CPAP and the importance of precision medicine in this scenario.","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"9 1","pages":"43 - 47"},"PeriodicalIF":2.2,"publicationDate":"2016-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S70402","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68363352","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}