Factors Of Blood Pressure Control Research Articles

Prevalence of hypertension, blood pressure control and influencing factors in residents aged 35-75 years in Jiangsu Province

Objective: To understand the prevalence, blood pressure control, and influencing factors of hypertension in residents aged 35-75 years in Jiangsu Province, and provide data support and basis for hypertension prevention and treatment. Methods: A stratified cluster sampling method was adopted to conduct community population surveys in 22 districts and counties in 12 prefectures in Jiangsu from 2021 to 2022. A total of 123 531 permanent residents aged 35-75 years were included in the study. The questionnaire survey collected the information about the demographic characteristics, disease history, lifestyle, and control of hypertension of study subjects. Statistical software SPSS 23.0 was used for χ2 test and multivariate logistic regression analysis, and Joinpoint 4.9.1.0 software was used to evaluate the trend of age change. Results: The standardized prevalence of hypertension in study subjects was 46.60%, the prevalence was higher in men than in women, and in rural residents than in urban residents, and the standardized blood pressure control rate was 11.24%, and it was lower in men than in women and in rural residents than in urban residents. The hypertension prevalence and control rates showed increasing trends with age (both P<0.001). The multivariate analysis results showed that being man, older age, being rural resident, higher frequency of alcohol consumption, marital status of being separated and widowed, overweight and obese, abdominal obesity and stroke, diabetes mellitus and dyslipidaemic diseases histories, and family history of hypertension were risk factors for hypertension, and being man, being rural resident, living north area, higher frequency of alcohol consumption, and obesity were risk factors for blood pressure control. Conclusions: The prevalence of hypertension in residents aged 35-75 years in Jiangsu was high, and the rate of blood pressure control was low. It is suggested to take integrated intervention measures, especially in in rural residents and people with low levels of education to reduce the disease burden of the patients.

Adherence to antihypertensive medication and its associated factors among patients with hypertension attending a tertiary hospital in Kathmandu, Nepal.

Hypertension is a major risk factor for cardiovascular disease, which is the leading cause of premature mortality and morbidity globally. Despite the evidences of the availability of effective treatment for hypertension, its management remains suboptimal. Medication adherence is the most crucial factor for blood pressure control. It is important to identify the factors associated with adherence to antihypertensive treatment for better management. Hence, this study assessed the level of antihypertensive medication adherence and its associated factors among patients with hypertension visiting a tertiary-level hospital in Kathmandu, Nepal. An analytical cross-sectional study was carried out among 308 diagnosed patients with hypertension who were prescribed antihypertensive medication. The Morisky Medication Adherence Scale (MMAS-8) was used to assess medication adherence. Data was collected through face-to-face interviews and analysed using SPSS v26. A bivariate and multivariate logistic regression model was used to assess the factors associated with low medication adherence. More than half (61%) of the study participants had moderate to high levels of medication adherence. Upon bivariate analysis, there was a significant association between presence of side effects, blood pressure status, forgetfulness, high cost, fear of taking medicine lifelong and irregular follow-up with a low level of adherence. Upon multivariate the logistic regression analysis, forgetfulness [Adjusted Odd's Ratio (AOR) 22.5, 95% Confidence Interval(CI) 10.56-47.86], high cost (AOR 3.8, 95%CI 1.25-11.60) and fear of taking medicines lifelong (AOR 6.04, 95%CI 2.96-12.33) were found to be associated factors of low level of adherence. There is an urgency to develop evidence-based strategies to improve the level of adherence to antihypertensive medications among patients with hypertension. Strategies like reminder messaging, setting alarms, expanding the scope of national health insurance and proper counselling to reduce fear could help to improve medication adherence. Hence, the feasibility and effectiveness of such intervention should be explored in future studies.

Catestatin-A Potential New Therapeutic Target for Women with Preeclampsia? An Analysis of Maternal Serum Catestatin Levels in Preeclamptic Pregnancies.

Catestatin has been identified as an important factor in blood pressure control in non-pregnant adults. A possible impact on the development of hypertensive disorders of pregnancy has been indicated. Data on catestatin levels in pregnancy are scarce. The aim of this study was to investigate a potential association of maternal serum catestatin levels to the pathogenesis of preeclampsia. We evaluated serum catestatin levels of 50 preeclamptic singleton pregnancies and 50 healthy gestational-age-matched pregnancies included in the obstetric biobank registry of the Medical University of Vienna. Receiver operating characteristic curves and logistic regression models were performed to investigate an association between catestatin levels and development of preeclampsia. Catestatin levels were significantly decreased in women with preeclampsia compared to healthy controls (median CST: 3.03 ng/mL, IQR [1.24-7.21 ng/mL] vs. 4.82 ng/mL, IQR [1.82-10.02 ng/mL]; p = 0.010), indicating an association between decreased catestatin values and the development of preeclampsia. There was no significant difference in catestatin values between early-onset preeclampsia and late-onset preeclampsia. Modelling the occurrence of preeclampsia via logistic regression was improved when adding catestatin as a predictive factor. Decreased serum catestatin levels are associated with the presence of preeclampsia. Further investigations into the diagnostic value and possible therapeutic role of catestatin in preeclampsia are warranted.

Influence of Internet-Based Health Management on Control of Clinical Parameters in Patients With Hypertension: Four-Year Longitudinal Study

In recent years, more and more studies have shown that internet-based health management can help patients with hypertension control their blood pressure. However, there is a lack of similar research in China. We designed this study to clarify the impact of long-term internet-based health management on the control of clinical parameters in patients with hypertension. These results are also expected to identify the relevant factors affecting the control of clinical parameters in hypertension more accurately toward developing more targeted health management strategies. This was a longitudinal study of internet-based health management in the five provinces of northwest China. The inclusion criteria were aged ≥18 years and no serious cognitive disease or mental disorder. After collecting the physical examination data of 8567 people in the five northwest provinces in 2013, we conducted online health management (including diet, exercise, and behavior) and follow-up. In the physical examination in 2013, 1008 new patients with hypertension were identified, who were divided into a good blood pressure control group and poor blood pressure control group. Physical examination and a questionnaire survey were conducted every 2 years to understand the changes of health management on the subjects' health-related behaviors. We then analyzed the changes of clinical indicators related to hypertension and the influencing factors related to blood pressure control in patients with hypertension. All statistical analyses were performed using R software (version 4.1.2) and a P value <.05 was considered statistically significant. A total of 8567 people met the inclusion criteria and underwent health management. Self-comparison showed that after 4 years of health management, the smoking cessation rate and amount of exercise significantly increased (both P<.001). The low-density lipoprotein-cholesterol levels also increased (P=.005), whereas the high-density lipoprotein-cholesterol levels decreased (P=.007). The newly discovered patients with hypertension in 2013 were further screened. After 4 years of health management, their smoking cessation rate increased significantly (P=.03) and the amount of exercise increased but not significantly (P=.08). In terms of clinical indicators, the diastolic blood pressure considerably decreased (P<.001) and the systolic blood pressure slightly decreased (P=.13). The correlation analysis of blood pressure control in patients with new-onset hypertension showed that gender (female) and changing relevant factors according to health management behaviors (BMI; cereals and potatoes intake; fish, livestock meat, and eggs intake; fruit intake; and physical activity) were the protective factors of blood pressure control. Internet-based health management has a significant and long-term effect on blood pressure control in patients with hypertension.

Vascular nitrosative stress in hypertension induced by fetal undernutrition in rats

Fetal undernutrition predisposes to hypertension development. Since nitric oxide (NO) is a key factor in blood pressure control, we aimed to investigate the role of NO alterations in hypertension induced by fetal undernutrition in rats. Male and female offspring from dams exposed to undernutrition during the second half of gestation (MUN) were studied at 21 days (normotensive) and 6 months of age (hypertension developed only in males). In aorta, we analyzed total and phosphorylated endothelial NO synthase (eNOS, p-eNOS), 3-nitrotyrosine (3-NT), and Nrf2 (Western blot). In plasma we assessed l-arginine, asymmetric and symmetric dimethylarginine (ADMA, SDMA; LC–MS/MS), nitrates (NOx, Griess reaction), carbonyl groups, and lipid peroxidation (spectrophotometry). In iliac arteries, we studied superoxide anion production (DHE staining, confocal microscopy) and vasodilatation to acetylcholine (isometric tension). Twenty-one-day-old MUN offspring did not show alterations in vascular e-NOS or 3NT expression, plasma l-Arg/ADMA ratio, or NOx. Compared to control group, 6-month-old MUN rats showed increased aortic expression of p-eNOS/eNOS and 3-NT, being Nrf2 expression lower, elevated plasma l-arginine/ADMA, NOx and carbonyl levels, increased iliac artery DHE staining and reduced acetylcholine-mediated relaxations. These alterations in MUN rats were sex-dependent, affecting males. However, females showed some signs of endothelial dysfunction. We conclude that increased NO production in the context of a pro-oxidative environment, leads to vascular nitrosative damage and dysfunction, which can participate in hypertension development in MUN males. Females show a better adaptation, but signs of endothelial dysfunction, which can explain hypertension in ageing.

Prescribing patterns and pharmacoeconomic analysis of antihypertensive drugs in South Indian population: A cross-sectional study.

Global evidence-based recommendations for hypertension management are periodically updated, and ensuring adherence to the guidelines is imperative. Furthermore, the current high prevalence of hypertension effectuates a high health-care cost. To evaluate the prescribing patterns of antihypertensive drugs and other factors affecting blood pressure (BP) with the objective of assessing the proportion of patients achieving the target BP and to perform a pharmacoeconomic analysis in a South Indian population. In a cross-sectional study, 650 patients previously diagnosed with hypertension and already on treatment with one or more drugs were included. A prospective interview of patients was done using a prevalidated questionnaire on various factors in BP control. Prescribing patterns and pharmacoeconomic analyses, namely, cost acquisition, cost of illness, and cost-effectiveness analyses were carried out. Of 650 subjects, 257 (39.54%) achieved the target BP, while 393 (60.46%) did not. A significant association of age, occupational status, monthly family income, and area of residence in addition to physical activity and diet scores, with achieving target BP was noted. A significantly higher cost of anti-hypertensive drug treatment in achieving target BP (P = 0.02) was observed. Among patients who achieved target BP, 37.35% were on monotherapy and 48.25% on multiple drug therapy compared to 46.31% and 35.62%, respectively, in patients who did not. Average cost-effectiveness ratio were found to be Rs. 20.45 and Rs. 57.27, respectively, for single and multiple drug therapies, with incremental cost-effectiveness of Rs. 194.14 per additional patient treated with multiple free drug combinations. This study identified the anti-hypertensive prescribing pattern and provided insight into the various pharmacoeconomic factors that play a significant role in attaining target BP in the treated population.

Status and influencing factors of blood pressure control among 35 – 74 years old community hypertensive patients in Luohu district of Shenzhen, 2019

Objective To investigate the condition and impact factors of blood pressure control among 35 – 74 years old hypertension patients in Luohu district, Shenzhen city of Guangdong province and to provide evidences to improve health management of the patients. Methods Using stratified random sampling, we recruited 1 205 hypertension patients aged 35 – 74 years at 10 community health service centres affiliated to Shenzhen Luohu Hospital Group. Face-to-face interviews with a self-designed questionnaire, physical examination and laboratory test were conducted among the patients during February 2019. Results Of all the patients, 618 (51.3%) had their blood pressure well-controlled. The results of unconditional multivariate logistic regression analysis showed that the patients with following characteristics were more likely to have well-controlled blood pressure: with locally registered permanent residence (odds ratio [OR] = 1.379, 95% confidence interval [95% CI]: 1.088 – 1.748), taking antihypertensive medication regularly (OR = 1.598, 95% CI: 1.173 – 2.177), and having a physical examination every year (OR = 1.578, 95% CI: 1.221 – 2.040); the results also revealed that male patients were less likely to have well-controlled blood pressure (OR = 0.762, 95% CI: 0.603 – 0.963) compared to female patients. Conclusion Among 35 to 74 years old community hypertension patients in Luohu district of Shenzhen city, the blood pressure control rate was relatively high and was mainly influenced by gender, whether having local household registration, whether having antihypertensive medication regularly and whether taking a physical examination every year.

Antidepressant treatment and blood pressure control in patients with comorbid depression and treatment resistant hypertension

BackgroundThough inconsistent, the majority of studies support an association between depression and incident hypertension and poor blood pressure control. However, none have investigated whether antidepressant medication (ADM) therapy is associated with blood pressure control in patients with comorbid depression and treatment resistant hypertension. MethodsOptum® de-identified Electronic Health Record data (2010–2018) were used to create a retrospective cohort of patients (≥18 years of age) with comorbid depression and treatment resistant hypertension. Patients were categorized into adequate ADM, inadequate ADM and no ADM treatment. A modified Poisson regression approach with robust error variance was used to estimate the association between ADM status and blood pressure control before and after adjusting for covariates. ResultsPatients were, on average, 55.7 (SD ± 9.9) years of age, 63.9% were female, 76.2% were white and 19.2% Black race. In crude models, inadequate ADM (RR = 1.06; 95%CI:1.01–1.11) and adequate ADM (RR = 1.08; 95%CI:1.03–1.14), compared to no ADM treatment, were associated with blood pressure control. After adjusting for covariates this relationship was attenuated and no longer significant. ConclusionsThe modest association between ADM therapy and blood pressure control in patients with treatment resistant hypertension is largely explained by traditional risk factors for hypertension such as obesity and older age. Treating depression is not a robust factor in blood pressure control among those with treatment resistant hypertension.

The Factors Correlated With the Blood Pressure Control Among the Elderly Hypertension in Hangzhou

Abstract Background To evaluate the effectiveness of community health management of elderly hypertension, and to describe the status and related risk factors of blood pressure control. Methods This was a cross-sectional study. Hypertensive patients aged 60 years and above who took part in community health management in Hangzhou were selected. Data on lifestyle, obesity, blood lipids, fasting plasma glucose, and blood pressure were collected. Systolic blood pressure ≥140 and/or diastolic blood pressure ≥90 mm Hg were used to calculate the blood pressure control rate. Results There were 209,768 subjects with mean age (70.7 ± 7.1) years in the present study. The mean value of systolic and diastolic blood pressures was (141.4 ± 16.9) and (80.2 ± 10.0) mm Hg, respectively. The blood pressure control rate was 48.39%. The rate of the subjects with unhealthy lifestyles, obesity (or central obesity), dyslipidemia, and abnormal fasting plasma glucose was 86.27%, 38.20%, 58.16%, and 14.72%, respectively. The unhealthy lifestyle, obesity, abnormal fasting plasma glucose, and dyslipidemia, affected blood pressure control rate, with an odds ratio (95% confidence interval) of 1.18 (1.15–1.21), 1.23 (1.21–1.25), 1.44 (1.40–1.48), and 1.10 (1.09–1.11), respectively. When 4 risk factors were combined, odds ratio (95% confidence interval) was 1.96 (95% confidence interval 1.83–2.09) for poor blood pressure control. Overall, the percentage of isolated systolic hypertension was 34.87% and increased with age. Conclusions The blood pressure control rate of the elderly hypertension patients in the community health management by national essential public health service was 48.39%. Obesity, unhealthy lifestyle, abnormal fasting blood glucose, and dyslipidemia are risk factors of poor blood pressure control and have cumulative effects.

The blood pressure control and arteriosclerotic cardiovascular risk among Chinese community hypertensive patients

The present study aimed to describe the blood pressure (BP) control rate and 10-years arteriosclerotic cardiovascular disease (ASCVD) risk estimation among community hypertensive patients. A total of 196,803 subjects were enrolled. The control rates calculated as the intensive (SBP < 130 mmHg and DBP < 80 mmHg) and standard (SBP < 140 mmHg and DBP < 90 mmHg) threshold. Multivariable logistic analysis was employed to assess the associations between cardiovascular factors and BP control. Sensitivity, specificity and Youden’s index were used to identify the ability of high risk of ASCVD estimation by different thresholds. The control rate was 16.34% and 50.25% by the intensive and standard threshold, respectively. Besides regular medication, the risk factors for BP control included older age, male, unhealthy lifestyle, obesity, dyslipidemia and abnormal FPG. 25.08% of subjects had high risk of 10-years ASCVD estimation. The sensitivity, specificity and Youden’s index of intensive threshold was 84.37%, 16.15% and 0.51%, and were significantly different from 50.55%, 50.42% and 0.98% of the standard threshold, respectively. Half of community hypertensive patients did not control BP, and nearly a quarter have high risk of 10-years ASCVD risk estimation. The intensive threshold resulted in a one-third reduction in the control rate compared to the standard threshold. No matter which threshold was used, a single BP control status seemed not a suitable indicator for identification of high risk of 10-years ASCVD risk estimation.

PHONE CALLS FOR IMPROVING BLOOD PRESSURE CONTROL AMONG HYPERTENSIVE PATIENTS ATTENDING PRIVATE MEDICAL PRACTITIONERS IN INDIA: FINDINGS FROM MUMBAI HYPERTENSION PROJECT

Objective: Despite the availability of effective medication, blood pressure control rate is low, particularly in low- and middle-income countries. Adherence to medication and follow-up visits are important factors in blood pressure control. This study assessed the effectiveness of reminder telephone calls on follow-up visits and blood pressure control among hypertensive patients as part of the Mumbai Hypertension Project. This project was initiated by PATH with the support from Resolve to Save Lives (RTSL) from January 2019 to February 2020. The study included hypertensive patients attending 164 private practitioners in Mumbai, India; practitioners screened all adults visiting clinic during the project period. Among 13184 hypertensive patients registered, the mean age was 53 years (SD = 12.38), 52% were female and 96% provided phone number. 9528 (72%) patients responded to a telephone call at least once during the study period. 82% of patients visited the clinic for follow-up visit within one month after receiving the phone call. The blood pressure control rate among those who answered phone calls and who did not answer phone calls increased from 21.0% to 44.3% (P &lt; 0.001) and 22.8% to 48.8% (P &lt; 0.001), respectively. The blood pressure control rate at follow-up was significantly associated with phone calls (OR: 1.51, 95% CI: 1.34 - 1.71). The study demonstrates that follow up visits and telephone call intervention can improve patient retention in care and subsequently, blood pressure control among hypertensive patients attending urban private-sector clinics in India.

Phone calls for improving blood pressure control among hypertensive patients attending private medical practitioners in India: Findings from Mumbai hypertension project.

Despite the availability of effective medication, blood pressure control rates are low, particularly in low‐ and middle‐income countries. Adherence to medication and follow‐up visits are important factors in blood pressure control. This study assessed the effectiveness of reminder telephone calls on follow‐up visits and blood pressure control among hypertensive patients as part of the Mumbai Hypertension Project. This project was initiated by PATH with the support from Resolve to Save Lives from January 2019 to February 2020. The study included hypertensive patients attending 164 private practices in Mumbai, India; practitioners screened all adults visiting their clinic during the project period. Among 13 184 hypertensive patients registered, the mean age was 53 years (SD = 12.38) and 52% were female. Among the 11 544 patients that provided phone numbers and gave consent for follow‐up calls, 9528 responded to phone calls at least once and 5250 patients followed up at least once. Of the 5250 patients, 82% visited the clinic for follow‐up visit within one month after receiving the phone call. The blood pressure control rate among those who answered phone calls and who did not answer phone calls increased from 23.6% to 48.8% (P <.001) and 21.0% to 44.3% (P <.001), respectively. The blood pressure control rate at follow‐up was significantly associated with phone calls (OR: 1.51, 95% CI: 1.34 ‐ 1.71). The study demonstrates that telephone call intervention and follow‐up visits can improve patient retention in care and, subsequently, blood pressure control among hypertensive patients attending urban private sector clinics in India.

Blood pressure control in hypertensive patients and its relation with exercise and exercise-related behaviors: A case-control study.

The effects of exercise interventions on blood pressure control in hypertensive patients have received extensive attention and recognition. However, the influence of exercise-related behaviors on the effects of blood pressure control and the management factors that affect exercise behaviors remain inconclusive. Therefore, this study aimed to explore the relationships between exercise and exercise-related behaviors and blood pressure control, expecting to provide a scientific basis for further improvement of exercise intervention programs for patients with hypertension.Long-term residents in a community in Fuzhou, Fujian Province, China who were diagnosed with hypertension at a medical facility were recruited for this study. Hypertensive patients with uncontrolled blood pressure were placed in the case group, and those with controlled blood pressure were placed in the control group. The count data were analyzed with the χ2 test based on α = 0.05. A univariate logistic regression analysis was performed to screen significant variables; independent variables were selected based on professional knowledge and were tested for co-linearity. These variables were incorporated into a non-conditional multivariate logistic regression analysis to analyze relevant factors for blood pressure control, while calculating odds ratio (ORs), 95% confidence intervals (CIs), and P values. Differences with a P < .05 were considered statistically significant.A total of 598 patients were included in the present study. Univariate and multivariate analyses showed that exercise (OR = 0.194; 95%CI: 0.133–0.283), frequency of self-monitoring of blood pressure (OR = 2.412; 95%CI: 1.137–5.117), and regular housework (OR = 0.397, 95%CI: 0.248–0.633) were statistically significant factors for blood pressure control. In addition, there was a relationship between exercise-related behaviors and blood pressure control: walking (OR = 0.189, 95% CI: 0.065–0.551), 60 to 120 min/day of exercise time (OR = 0.317, 95% CI: 0.118–0.856). Sex (OR = 2.248, 95% CI: 1.279–3.954), health belief (OR = 0.016, 95% CI: 0.004–0.059), and company of a family member during exercise (OR = 0.048, 95% CI: 0.025–0.094) were significant factors predictive of regular exercise in hypertensive patients.Improving exercise-related behaviors and their management can help improve the effects of exercise interventions on blood pressure control in middle-aged and elderly hypertensive patients.

Knowledge and Associated Factors of Blood Pressure Control Among Hypertensive Patients Attending Chronic Illness Follow-Up Clinic at University of Gondar, Comprehensive Specialized Hospital, Northwest, Ethiopia.

IntroductionAs hypertension is a chronic cardiovascular disease that contributes to a high proportion of morbidity and mortality worldwide, favorable knowledge is crucial to control it.ObjectiveThe objective of this study was thus to assess knowledge and associated factors of blood pressure control among hypertensive patients at the chronic illness follow-up Clinic of the University of Gondar comprehensive-specialized hospital, Gondar, Ethiopia.MethodsAn institution-based cross-sectional study was conducted from March to April 2018. A systematic random sampling technique was used to select participants. Bi-variable and multivariable logistic regressions were done to assess the relationship between dependent and independent variables. The adjusted odds ratio with a 95% confidence interval was used to determine the presence and strength of association between covariates and the outcome variable.ResultsA total of 404 participants took part in the study with a response rate of 97.3%. The overall good knowledge about blood pressure control was 51.7% (95% CI=46.3–56.8). Females were 3.79 (AOR= 3.79, 95% CI: (1.55, 9.28)) more knowledgeable about blood pressure control than males. In the multivariable analysis, the odds of being knowledgeable were 2.80 (AOR= 2.80, 95% CI (1.44, 5.46)), 8.05 (AOR=8.05, 95% CI (2.93, 22.10)), and 7.53 (AOR=7.53, 95% CI (2.52, 22.49)) for can read and write, secondary, preparatory and above education, respectively, compared to cannot read and write. Occupation was significantly associated with the knowledge of plod pressure control. For example, merchants 7.66 (AOR=7.66, 95% CI (3.01, 19.47)), government employee 6.33 (AOR=6.33, 95% CI (1.90, 22.07)), and self-employed 4.58 (AOR=4.58, 95% CI (1.80, 11.70)) times more likely to be knowledgeable than farmers, respectively. Participants with family history of hypertension were 2.36 (AOR=2.36, 95% CI (1.42, 3.92)) times more knowledgeable than their counterparts.ConclusionIn this study, knowledge of blood pressure control was lower compared to the finding of a study done at Bishoftu hospital, Ethiopia. But it is higher than studies in other African countries. Both pharmacological and non-pharmacological awareness is vital for blood pressure control.

Prevalence and factors affecting uncontrolled hypertension among hypertensive patients in a rural community, Thailand

Introduction Hypertension is a non-communicable disease, considered as a major problem of public health worldwide including Thailand. National Health Education Standards indicate that the prevalence of uncontrolled hypertension in hypertensive patients is about 19.5%. Thus, people in Thailand are likely to suffer from chronic disease as well as complications of hypertension, which potentially raises the risk of cardiovascular disease and kidney disease. These results in lower quality of life among hypertensive patients and further contribute to society and economic problems. Objective To determine the prevalence and associated factors of blood pressure control in hypertensive patients in Baan Na Yao community, Chachoengsao Province and Baan Phra Ploeng community, Sa Kaeo Province. Material and methods A cross-sectional study was performed. Blood pressure measurement and anthropometric data were measured and recorded. Standardized questionnaires were used in quantitative study to collect demographic data and factors associated with blood pressure control. The factors included dietary behaviors, physical activities, antihypertensive medication used and information of healthcare service. The collected data were processed using statistical analysis. Results The sample of hypertensive population from Baan Na Yao was 178 (43.8%) and Phra Phloeng was 228 (56.2%). The majority of hypertensive patients were female (72.4%). The prevalence of all age groups was mostly in the range between 60 to 69 years old (38.4%). The overall prevalence of uncontrolled hypertension among hypertensive patients was 54.4%. Multivariate logistic regression analysis was performed. The factors associated with uncontrolled hypertension including poor drug adherence, neck circumference more than or equals to 35.75 centimeters in male and 32.75 centimeters in female, adding fish sauce to meals, and sedentary hours of more than six per day. Conclusion Uncontrolled hypertension is a major problem in the rural community. Therefore, primary care unit (PCU) and village health volunteers have an important role to educate people and patients in the rural community to fully understand and be aware of their own disease condition in order to maintain their quality of life.

Effectiveness Usual Counseling by Pharmacist of RSUD A.W. Sjahranie Samarinda to Improve Medication Compliance in Hypertension

Compliance to antihpertensive medications represents a success factor for blood pressure control in clinical practice. Medical non-compliance has been identified as a major public health problem in the treatment of hypertension. This study evaluated an additional usual counseling could achieve optimal BP control. This experimental study uses cohort study design using prospective patient data collection in patients with hypertension, and hypertension with complications at RSUD A.W.Sjahranie SAMARINDA from Juli 2014-Oktober 2014. Data were collected by interviews and questionnaires; meanwhile the patient's blood pressure data were taken from the medical record. A total of 61 patients. The results showed that there were not significant different in change BP control and compliance level wilcoxcon (p&gt;0,05). The compliance status in usual counseling relatively poor. Phamacist counseling are important to improve medication compliance in hypertension

Observation of the effect of community standardized management of hypertension and analysis of its influencing factors

Objective To study the blood pressure control and its influencing factors in community standardized management of hypertension patients, to provide basis for clinical diagnosis and treatment. Methods 120 hypertension patients with community standardized management were selected as study group, another 120 hypertension patients were selected as control group.The blood pressure control was compared between the two groups, and the influencing factors were analyzed. Results The systolic and diastolic blood pressur before treatment between the two groups had no statistically significant differences (all P>0.05). The systolic blood pressure, diastolic blood pressure after administration of the study group were (129.4±3.2)mmHg, (87.5±2.8)mmgHg, which in the control group were (138.3±10.1)mmHg, (95.7±4.3)mmHg, the differences were statistically significant compared with before treatment (t=9.478, 9.074, 8.278, 8.687, all P<0.05), the differences between the two groups were statistically significant (t=7.654, 7.061, all P<0.05). Logistic regression analysis showed that age, body mass index, obesity, smoking, blood pressure level, taste and triglyceride were the influencing factors of blood pressure control(OR=20.564, 0.995, 0.746, 1.092, 0.749, 1.153, 0.854, all P<0.05). Conclusion Community standardized management can enhance the effect of blood pressure control, age, body mass index, obesity, blood pressure level, smoking and so on are the influencing factors. Key words: Hypertension; Community Health Services; Blood pressure; Factor

GW27-e1037 Analysis on the influencing factors of blood pressure control of hypertensive patients with community-based standardized management in Shenzhen Futian District

GW27-e1037 Analysis on the influencing factors of blood pressure control of hypertensive patients with community-based standardized management in Shenzhen Futian District

Assessment of medication adherence among hypertensive patients: a cross-sectional study

Background: Hypertension affects around one billion individuals worldwide and is expected to increase by 29% to reach 1.56 billion by 2025. It is usually asymptomatic, chronic disorder needing lifelong treatment. The objective of this study was to study the medication adherence among hypertensive patients using hill-bone compliance to high blood pressure therapy scale (HILL-BONE CHBPTS) and to compare medication adherence in hypertensive patients with controlled and uncontrolled blood pressure. Methods: A cross-sectional, observational study was conducted for a period of one year in the Outpatient department of Medicine in a tertiary care hospital, Navi Mumbai. A total of 129 hypertensive patients who were on at least six months on antihypertensive medications were enrolled. Blood pressure was measured and details of drug therapy were noted. Medication adherence was assessed using HILL-BONE CHBPTS and respective scores were calculated. Results: HILL-BONE CHBPTS scores were on the higher side signifying poor medication adherence among hypertensive patients. HILL-BONE CHBPTS score correlated significantly in a positive direction with diastolic blood pressure, duration of treatment and the number of medications, As per JNC 8 recommendations, 58.9% (76) hypertensive patients were having blood pressure under control, whereas 41.1% (53) were having uncontrolled blood pressure. HILL-BONE CHBPTS scores were significantly higher (reflecting lower adherence) in hypertensive patients with uncontrolled blood pressure than those having optimally controlled blood pressure. Conclusions: Overall the medication adherence was poor in hypertensive patients. Adherence to therapeutic regimens is an important factor in blood pressure control among hypertensive patients and needs priority. Health education related to medication adherence needs be improved in hypertensive patients.

Improvement and influencing factors of blood pressure control by nephrologist referral in chronic kidney disease patients in China: a cohort study

Hypertension is an independent risk factor for mortality in chronic kidney disease (CKD) and is suboptimally controlled worldwide. Therefore, this study aimed to examine the rate of BP control and the main barriers to achieving target BP, according to K/DOQI guidelines, in China. We performed a single-center, prospective cohort study. Two hundred and sixty CKD patients were referred by general physicians to nephrologists, and their BP was treated in accordance with K/DOQI guidelines for a 1-year follow-up. We evaluated improvement of BP target achievement and factors affecting BP control. We defined "not-at-goal" as persistence of systolic BP ≥ 130 mmHg and/or diastolic BP ≥ 80 mmHg after 1 year. The BP decreased from 138 ± 12/84 ± 7 mmHg at baseline to 124 ± 13/73 ± 7 mmHg after 1 year. The rate of achieving the BP goal (<130/80 mmHg) increased from 25.4 to 61.5 %. The decrease in BP was associated with a significant reduction of proteinuria (median, 0.14 vs 0.06 g/24 h; P < 0.05). Logistic regression analysis identified proteinuria levels ≥1.0 g/24 h (odds ratio [OR]: 5.21; 95 % confidence interval [CI]: 1.37-19.77) and high basal systolic BP (OR: 2.17; 95 % CI: 1.25-3.77) and diastolic BP (OR: 6.62; 95 % CI: 2.03-21.60) as independent predictors of not-at-goal BP. Higher educational level was independently associated with at-goal BP (OR: 0.21; 95 % CI: 0.06-0.78). In CKD patients, BP control is poor when managed by general physicians and may be improved after nephrologist referral. High basal BP and proteinuria levels ≥1.0 g/24 h are the main barriers that preclude the optimal control of BP.