신규 고혈압 환자에서 치료지속성이 고혈압 조절에 미치는 영향

한진욱 ( Jin Ok Han ),오대규 ( Dae Kyu Oh ),임준 ( Jun Yim ),고광필 ( Kwang Pil Ko ),이희영 ( Hee Young Lee ),박종헌 ( Jong Heon Park ),임정수 ( Jeong Soo Im ) 한국보건행정학회 2014 보건행정학회지 Vol.24 No.2

Background: This study is to research on how hypertension control is associated with adherence in newly diagnosed hypertension patients. Methods: The study is based on 255,916 patients who were diagnosed with hypertension in 2009 and didn`t have any previous medical history of hypertension or associated complication for the past year using data collected by National Health Insurance Corporation. Newly diagnosed hypertension patients are divided into two group by visiting medical center numbers (more than 300 days was adherence group, if not non-adherence group). Patients are considered to have successfully controlled their hypertension based on blood pressure measured by health examination. Chi-square test and logistic regression, repeated measured analysis of variance was used to analyze. Results: The relations between adherence and hypertension control show that 1.12 times of patients in adherence group was able to control their hypertension. The additional analysis proves that adherence group are more decreased level of blood pressure than non-adherence group except for patients who are over 70. Comparison of the average of systolic blood pressure and diastolic blood pressure between adherence and non-adherence groups shows that the blood pressure has been significantly among the adherence group. Conclusion: The study proves that constant treatment for hypertension could control the blood pressure and encourages patients to put more effort for persistent treatment. It also shows that hypertension treatment are more effective in younger patients than the elderly and strategies of approaching are different depending on age.

Remifentanil과 Lidocaine이 고혈압 환자에서 기관내삽관 시 심혈관계 반응에 미치는 효과

강효석 ( Hyo Suk Kang ),유수봉 ( Soo Bong Yu ),김두식 ( Doo Sik Kim ),류시정 ( Sie Jeong Ryu ),장태호 ( Tae Ho Chang ),김세환 ( Se Hwan Kim ),김경한 ( Kyung Han Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.1

Background: Hypertensive patients are more prone to exhibit an exaggerated hemodynamic responses to laryngoscopy and tracheal intubation. We compared the effects of remifentanil and lidocaine on the cardiovascular responses during intubation in hypertensive patients. Methods: Fifty adult hypertensive patients (>140/90 mmHg) were divided into 2 groups (remifentanil group; 1.0 μg/kg, n=25, lidocaine group; 1.5 mg/kg, n=25). After 3 minutes`oxygenation, anesthesia was induced using 0.2 mg glycopyrrolate, 1.5 mg/kg propofol, and 1 of experimental drugs (30 seconds) bolus administration. Tracheal intubation was facilitated 90 seconds after administration of rocuronium; anesthesia was maintained with 2% sevoflurane and air in oxygen. Arterial blood pressure and heart rate were measured at the following times: resting state (baseline), after oxygenation; before intubation; just after intubation; and at 1, 3, and 5 minutes after intubation. Results: There was significant attenuation of mean systolic and diastolic arterial blood pressures, after intubation of the remifentanil group compared to the lidocaine group at just after intubation and at 1 minute after intubation (P<.05). The difference in heart rate was not significant between both groups. Conclusions: Bolus administration of remifentanil was found to be superior to lidocaine in the attenuation of the blood pressure during intubation in hypertensive patients. (Korean J Anesthesiol 2009; 57: 20~5)

Clinical Safety of Chemotherapy for Elderly Cancer Patients Complicated with Hypertension

Qian, Ya-Dong,Xu, Xu,Wang, Lin,Huang, Xin-En Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.22

Objective: To access the safety of chemotherapy for elderly cancer patients complicated with hypertension. Methods: Elderly cancer patients who were complicated with hypertension and treated by chemotherapy were recruited. All patients were treated by chemotherapy after an intervention on hypertension by psychotherapy, exercise guidance, salt regulation and nutrition support, therapy on hypertension, as well as prevention on hypertension associated complications. Results: In 68 eligible patients, two suspended chemotherapy because of adverse reactions and 4 because of disease progression. The remaining 62 patients completed chemotherapy smoothly based on good hypertension control. Conclusion: With effective control of blood pressure, chemotherapy for elderly cancer patients complicated with hypertension is generally safe.

고혈압 환자와 보건소 간호사의 고혈압 관련 용어 이해 차이

김묘성 ( Myo-sung Kim ),정인숙 ( Ihn-sook Jeong ) 경희대학교 동서의학연구소 2016 동서간호학연구지 Vol.22 No.1

Purpose: This study aimed to suggest hypertension-related vocabularies which hypertensive patients can understand easily. Methods: The survey was conducted from 267 hypertensive patients and 162 public health nurses in 8 community health centers in Busan from October 21 to November 8, 2013. Data were analyzed using SPSS program and included descriptive statistics, t-test, ANOVA, and χ2 test. Results: The mean score for 26 hypertension-related vocabularies comprehension of hypertensive patients was 16.1 out of 26 points. The score was significantly lower among participants who were women, older, less educated, had limited ability to read and write, and had worse self-rated health. Over half of them didn’t know the correct meaning of 9 out of 26 hypertension-related vocabularies. Twenty-two vocabularies such as hypertension that nurses used for health education were in different use, patients understand. Conclusion: Based on the results, it is recommended to educate hypertensive patients by replacing hypertension-related vocabularies with more easily understandable words when providing health information.

본태성 고혈압 환자의 고혈압 발생 위험요인 예측

이홍자,손행미 성인간호학회 1999 성인간호학회지 Vol.11 No.4

The purpose of this study wad to investigate the relation between hypertension and risk faction. A positive association between obesity, age, serum lipid and such life style factors as smoking, exercise, alcoholic beverage use with blood pressure problems and the prevalence of hypertension has been described in many studies. Therefore to identify and evaluate the effects of variables, which were known to be related to hypertension, multiple regression analysis was performed. We studies 110 subjects. The participants were 45 men and 65 woman who visited one university hospital located in Seoul from January to December 1998. All 110 persons were identified as having primary hypertension by their physicians. The significant risk factors identified for hypertension were Obesity, BMI, length of time with hypertension. The results were as follows ; 1. The systolic blood pressure average in 110 subjects was 156.65mmHg±14.08mmHg, the diastolic blood pressure average was 100.73mmHg±5.64mmHg. 18.2% of the subjects were smokers, 26.4% of the subjects were drinkers, and 33.6% of the subjects exercised regularly. 13.6% had a family history of hypertension. The average mean pressure was 119.37±7.40mmHg. The average history hypertension was 28.36±34.56months. The average BMI was 24.54㎏/㎡. The average serum cholesterol of the subjects was 204.54, HDL was 50.93㎎/dl. 2. The result of this study were that variables which showed significance rationale for high systolic blood pressure hypertension were mean arterial pressure(R²=0.808), and age(R²=0.032). And the variables which showed significance rationale for diastolic blood pressure in hypertension were mean arterial pressure(R²=0.014), and smoking(R²=0.010). And the best variable for prediction of mean blood pressure was the length of history of the disease. 3. According to multiple regression analysis by demographic variables, age and the length of history of hypertension. And mean the blood pressure was identified best explaining variable of hypertension by biophysical variables. Therefore, life style modification for hypertension patients as a primary regimen is less important than for normal blood pressure patients. Life style modification is important intervention for normal blood pressure subjects, on the other hand drug therapy and its compliance is the most important intervention for hypertensive subjects. So to regulate blood pressure and prevent the complication of hypertension, the first regime of all should pharmacologic compliance for primary hypertension patients.

고혈압 환자에서 혈장 내 Long-Chain Fatty Acids 성분 분석

김수경,김종선,권지윤 대한임상약리학회 2011 Translational and Clinical Pharmacology Vol.19 No.2

Background: Numerous studies have suggested that polyunsaturated fatty acids (PUFAs)-supplemented diets may decrease cardiovascular morbidity and mortality. Especially, ω-3 PUFAs may exert beneficial effects to the treatment and prevention of dyslipidemias, arrhythmias, atherosclerosis, and hypertension. Methods: This study investigated plasma lipid profiles including total cholesterol, triglycerides (TG), LDL, HDL, and antioxidant status indicative of vitamin A, vitamin E, malondialdehyde (MDA) and distribution of plasma long-chain fatty acids (C12-C24) in 28 normal subjects and 24 hypertensive patients. Also, the correlation among PUFAs, levels of antioxidant status, and lipid profiles of the subjects were estimated. Results: The distribution of ω-3 PUFAs, saturated fatty acids, and monounsaturated fatty acids showed significant differences (P<0.05), but that of ω-6 PUFAs did not exhibit significant differences. The ω-6/ω-3 ratio exhibited 36.96 in normal group and 14.29 in the hypertensive patient group. The levels of vitamin A, vitamin E, and MDA were increased significantly in the hypertensive patient group. Conclusion: PUFA levels were estimated in the hypertensive patients and normal group. The results suggest that dietary intake of proper ω-6/ω-3 ratio is needed for prevention and treatment of hypertension.

지역단위 고혈압사업에 있어서 환자의 치료순응도와 결정요인

김지,민경복,권순호,한달선,배상수,Kim, Jee,Min, Kyung-Bok,Kwon, Soon-Ho,Han, Dal-Sun,Bae, Sang-Soo 대한예방의학회 1999 예방의학회지 Vol.32 No.2

Objectives: To investigate compliance of hypertension patients using modified Theory of Reasoned Action(TRA). Methods: The data were collected for 7-12 April 1997, by interviewing 190 Hypertension patients in Hwachon, Kangwon-do. The analytical techniques employed include contingency table analysis and logit analysis. Results: 15.1% of patients were unaware of the fact that he/she has hypertension and 11.2% did not know that he/she should take drug. 20.8% of patients took drug continuously, 20.1% had drug intermittently, and 53.1% had never have treatment. In the contingency table analysis, several variables were found to be significantly related to patient compliance. They included variables for attitude towards the consequences of taking drugs, normative beliefs, systolic BP at the enrollment, knowledge of how to take hypertensive drugs, variables for general health behavior and experience with having health worker's home visit. The logit analysis was performed by two steps. first step uses experience with drug treatment of hypertension as the dependent variable, and second step uses continuity of treatment. Included in the predictors that are significantly related to the former analysis are subjected norms produced by combining normative beliefs and motivation to comply, knowledge of how to take hypertensive drugs, and opinion about natural recovery of diseases. The only significant determinant of continuous treatment was knowledge of how to take hypertensive drugs. Conclusions: The results of analysis suggest the usefulness of TRA as a framework for the study of compliance of hypertensive patients. The findings have some practical implication as well. One is that efforts for enhancing compliance should be directed not only patients but also to other persons influencing patient's attitude and behavior. It also suggest that correct understanding of hypertension treatment is essential to perform the appropriate patient role.

Modeling Adherence to Therapeutic Regimens in Patients with Hypertension

Roh Young Sook Korean Society of Nursing Science 2005 Journal of Korean Academy of Nursing Vol.35 No.4

Purpose. This study was done to identify and test a model of the psychosocial variables that influence adherence to therapeutic regimens in patients with hypertension. Method. A convenience sample of 219 patients with hypertension who were enrolled in an outpatient clinic of a cardiovascular center in Korea participated in the study. They completed self-administered questionnaires anonymously. The questionnaire was based on the Social Action Theory model and a literature review. The explanatory model was constructed and tested using structural equation modeling in order to examine the effects within the model. Results. The results of this study showed that perceived self-efficacy was the strongest factor influencing patient adherence in this sample. Adherence to therapeutic regimens in patients with hypertension was influenced by self-efficacy, patient-provider relationship, social support, and depression. Conclusions. Adherence to therapeutic regimens in patients with hypertension was most strongly influenced by self-efficacy. These findings suggest that nursing interventions to promote patient adherence should focus on the promotion of self-efficacy including improvement in patient-provider relationship and social support, and reduction in depression.

약물복용 중인 고혈압 환자의 혈압관리양상 예측을 위한 의사결정나무분석

김희선,정석희,박숙경 한국기초간호학회 2019 Journal of korean biological nursing science Vol.21 No.1

Purpose: This study was performed to analyze the levels of blood pressure and to identify good or poor blood pressure control (BPC) groups among hypertension patients. The study was based on the Korea National Health and Nutrition Examination Survey (KNHANES VI and VII) conducted from 2013 to 2016. Methods: The sociodemographic and clinical data of 4,151 Korean hypertension patients aged 20-79 years and who were taking antihypertensive medications was extracted from the KNHANES VI and VII database. Descriptive statistics for complex samples and a decision-tree analysis were performed using the SPSS WIN 24.0 program. Results: The mean age was 62.46±0.21 years. The mean systolic blood pressure (SBP) was 128.07±0.28mmHg, and the diastolic blood pressure (DBP) was 76.99±0.21mmHg. 71.9% of participants showed normal blood pressure (SBP <140mmHg and DBP <90mmHg). From the decision-trees analysis, the characteristics of participants related to good BPC group were presented with 9 different pathways same as those from the poor BPC group. Good or poor BPC groups were classified according to the patients’ characteristics such as age, living status, occupation, education, hypertension diagnosis period, numbers of comorbidity, perceived health status, total cholesterol, high density lipoprotein-cholesterol, alcohol drinking per month, and depressive mood. Total cholesterol level (<201mg/dL or ≥201mg/dL cutoff point) was the most significant predictor of the participants’ BPC group. Conclusion: This decision-tree model with the 18 different pathways can form a basis for the screening of hypertension patients with good or poor BPC in either clinical or community settings.

고혈압 환자의 생활양식과 삶의 질에 관한 구조 Model

이종렬 ( Jong Ryol Lee ),박천만 ( Chun Man Park ) 한국보건행정학회 2004 보건행정학회지 Vol.14 No.3

This study was intended to describe the hypertensive patient`s lifestyle and quality of life by creating a hypothetic model on the lifestyle and quality of life and by examining a causeand effect relationship, and to contribute to countermeasures for practicing their lifestyle and improving the quality of life through creating a predictable model. Exogenous variable(ξ) of hypothetic model in this study composed of a family support, hypertension knowledge, perceived benefit and toughness. Endogenous variable(η) composed of self-esteem, perceived health state, depression, lifestyle and quality of life. There were 6 measured variables for exogenous variable(x). There were 9 measured variables(y) for endogenous variable. Also, there was error variable (δ, ε) of an individual. The survey was conducted for 207 hypertensive parents who received an out-patient service for 3 weeks from September 15, 2003 to October 3, 2003 after diagnosing as hypertension from 2 general hospitals in Daegu. As the conformance of hypothetic model in this study, there were χ2=155.81, standard χ2(χ2/df)=2.32, GFI=0.903, NFI=0.971, CFI=0.982, and RMSEA=0.080. Generally, the hypothetic model and actual data were well coincided. The higher the hypertension knowledge was(t=6.030), the higher the perceived benefit was(t=9.429), the higher the toughness was(t=2.783), and the higher the perceived health state was(t=2.282), the higher the lifestyle was. However, the degree of depression (t=-0.038), family support(t=1.161), and self-esteem(t=0.518) was not affected. The higher the family support was(t=10.476), the higher the self-esteem was(t=7.244), the higher the perceived health state was(t=6.996), the lower the degree of depression was(t=-2.044), and the higher the practice degree of lifestyle was(t=3.315), the higher the quality of life was. However, the toughness(t=1.672) didn`t have a significant influence on the quality of life. It was modified to increase the model conformance and gain a conscious model As the result of model revision, for the model conformance, there were χ2=118.43, standard χ2=1.69, GFI=0.923, NFI=0.976, CFI=0.982, and RMSEA=0.078. As the revised model showed the better conformance than hypothetic model, it seemed to be more suitable model. In the revised model, the perceived benefit(t=9.440) affected the lifestyle in the revised model. Then, the lifestyle was influenced by hypertension knowledge(t=6.139), toughness(t=2.757), family support(t=2.078), perceived health state(t=1.962) in the order. As a factor which affected the quality of life, there were the family support(t=10.461), self-esteem(t=7.368), perceived health state(t=6.989), lifestyle(t=3.316), toughness(t=2.584), and depression(t=-1.968) in the order. It showed the significant effect.