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- 저자 : Almas Aysha (검색결과 2 건)
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Hunaina Shahab,Hamza Sohail Khan,Aysha Almas,Sohail Abrar Khan,Azmina Artani,Aamir Hameed Khan 대한고혈압학회 2019 Clinical Hypertension Vol.25 No.3
Background: Every third patient in the clinic is misdiagnosed due to white-coat phenomenon, necessitating needless and costly treatment. We aimed to study the hemodynamic response of the physician’s visit on hypertensive and normotensive patients by investigating the trend of blood pressure (BP) before, during and 15 min after the physician-patient encounter. Methods: A descriptive, cross-sectional study was conducted over a period of 8 months in the cardiology clinics at the Aga Khan University Hospital, Karachi. Both hypertensive and normotensive patients, aged ≥18 years, were recruited. Pregnant females or those with a history of volume loss were excluded. BP readings were taken using an automated, validated device (Omron-HEM7221-E) at three points: pre-clinic BP by the assessment nurse, in-clinic BP by the attending physician and post-clinic BP 15-min after the physician-patient encounter by a research assistant. Independent samples t-test was used to calculate the statistical difference between hypertensive and normotensive BP values. Results: Of 180 participants, 71% (n = 128) were hypertensive and 57% (n = 103) of all were males. The mean age of the participants was 57 ± 15 years. The mean and standard deviation(±SD) systolic BP (SBP) taken pre-clinic, inclinic and 15-min post-clinic for hypertensive population was 128.7 ± 20 mmHg, 137.1 ± 21 mmHg and 127.9 ± 19 mmHg. The mean and standard deviation(±SD) SBP taken pre-clinic, in-clinic and 15 min post-clinic for normotensive population was 112 ± 16 mmHg, 115.8 ± 20 mmHg and 111.8 ± 15 mmHg. The hypertensive SBP values showed statistically significant difference from the normotensive values (difference in pre-clinic SBP: 16. 7 mmHg, p-value < 0.001; in-clinic SBP: 21.3 mmHg, p-value < 0.001; and 15 min post-clinic: 16.1 mmHg, p-value < 0.001). Conclusions: Hypertensive and normotensive patients display congruent hemodynamics upon visiting the physician, the alert response being accentuated amongst the hypertensive group. In-clinic BP readings are higher for both hypertensive and normotensive patients making them unreliable for screening and management of hypertension amongst both the groups.
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Challenges of managing hypertension in Pakistan - a review
Elahi Adil,Ali Arzina Aziz,Khan Aamir Hameed,Samad Zainab,Shahab Hunaina,Aziz Namra,Almas Aysha 대한고혈압학회 2023 Clinical Hypertension Vol.29 No.-
Background This review aims to describe existing evidence on the state of hypertension in Pakistan, including the prevalence, associated risk factors, preventive strategies, and challenges in the management of hypertension. Methods A comprehensive literature search was conducted electronically using PubMed and Google Scholar. Using specific screening methodology, 55 articles were selected to be included. Results We found from this extensive review that several small studies report high prevalence of hypertension but there is a lack of population based prevalence of hypertension in Pakistan. Lifestyle risk factors such as obesity, unhealthy diet, decreased physical activity, low socioeconomic status, and lack of access to care were the main associated factors with hypertension. Lack of blood pressure monitoring practices and medication non-adherence were also linked to uncontrolled hypertension in Pakistan and were more evident in primary care setups. The evidence presented is essential for delineating the burden of the disease, hence allowing for better management of this underserved population. Conclusion There is a need for updated surveys to depict the true prevalence and management of hypertension in Pakistan. Cost-effective implementation strategies and policies at the national level are needed for both prevention and control of hypertension.
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