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Evaluation of Blood Pressure Control Levels and Treatment Compliances of Hypertensive Patients

Year 2013, Volume: 38 Issue: 2, 224 - 232, 01.06.2013

Abstract

Purpose: The aim of the study is to evaluate the knowledge of patients about hypertension (HT), compliance with lifestyle changes and to determine their blood pressure levels under antihypertensive therapy. Method: Hypertensive patients that applied to Family medicine outpatient clinics of Diskapi Yildirim Beyazit Education and Research Hospital for the first time, in 2012 (between February 1 to April 30), were included in our cross-sectional study. Patients are evaluated primarily for the control and the factors that can affect high blood pressure and the rate on achieving treatment goals. Results: Three hundred and forty patients were included in the study. The mean age of the patients was 60.5±10.7 years and 222 of them (65.3%) were female. The blood pressure was not under control in 108 (31.8%) patients. The mean body weight of male patients was statistically higher than females (p=0.015). The number of the patients that knew the normal blood pressure value was 249 (73.2%). Among those 155 (62.2%) were women and 179 (71.9%) were younger than 65 years of age (p=0.0001). Forty one patients (12.1%) were still smoking, 46 (13.5%) patients were exercising regularly and 32 (9.4%) were consuming regular diet. Blood pressure was better controlled in the group that was exercising regularly (p=0.001). The rate of male patients that were on regular exercise and diet, were higher than females (p=0.09). Only 86 patients (25.3%) knew the name of their antihypertensive medication and 65 of patients (19.1%) knew the dose of their medication. Female patients knew the name of their medication better than males (p=0.002). 156 patients (45.9%) were using two kinds of antihypertensive medication. 58 patients (17.1%) were skipping doses a few times a week. Conclusion: The knowledge of hypertensive patients on their illness and their compliance on non-drug treatments were inadequate. The compliance of patients should be improved by development of patient-doctor should be improved by development of patient-doctor relationship according to up-to-date guidelines

References

  • Danaei G, Finucane MM, Lin JK, Singh GM, Paciorek CJ, Cowan MJ et al. National, regional and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 4 million participants. Lancet. 2011;377:568
  • Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217–
  • Soydan İ: Hipertansiyon İle İlgili TEKHARF Çalışması Verileri ve Yorumları. In: Onat A (ed) TEKHARF: Türk Erişkinlerinde Kalp Sağlığı: Halkımıza İlişkin Temel Veri Üretiminden Evrensel Tıbba Katkıya. Argos Yayıncılık, İstanbul. 2005; 60
  • Centers for Disease Control and Prevention (CDC). Vital signs: prevalence, treatment, and control of hypertension—United States, 1999-2005 and 2005200 MMWR Morb Mortal Wkly Rep. 2011;60:103–
  • Llisterri Caro JL, Rodríguez Roca GC, Alonso Moreno FJ, et al. Control of blood pressure in Spanish hypertensive population attended in primary health-care. PRESCAP 2006 Study. Med Clin (Barc). 2008;130:681–7.
  • Llisterri Caro JL, Rodríguez Roca GC, Alonso Moreno FJ, Banegas Banegas JR, González-Segura Alsina D, Lou Arnal S, et al. Prevalence, awareness, treatment and control of hypertension in Portugal: The PAP study. J Hypertens. 2005;23:1661-6.
  • Altun B, Arici M, Nergizoğlu G, Derici U, Karatan O, Turgan C, Sindel S, et al. Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens. 2005;23:1817
  • Oliveria SA, Chen RS, McCarthy BD, Davis CC, Hill MN. Hypertension knowledge, awareness, and attitudes in a hypertensive population. J Gen Intern Med. 2005;20:219-25.
  • Whitworth JA. World Health Organization, International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/International
  • Society of Hypertension (ISH) statement on management of hypertension. J Hypertens. 2003;21:1983-92.
  • Psaty BM, Smith NL, Siscovick DS, Koepsell TD, Weiss NS, Heckbert SR, et al. Health outcomes assocaited with antihypertensive therapies used as first-line agents. JAMA. 1997;277:739-45.
  • Stamler J, Stamler R, Neaton JD. Blood pressure, systolic and diastolic, and cardiovascular risks: US population data. Arch Intern Med. 1993;153:598-615.
  • Kannel WB, Dawber TR, Kagan A, Revotskie N, Stokes J 3rd. Factors of risk in the development of coronary heart disease–six year follow-up experience. The Framingham study. Ann Intern Med. 1961;55:33-50.
  • Neal B, MacMahon S, Chapman N. Effects of ACE inhibitors, calcium antagonists, and other bloodpressure-lowering drugs: results of prospectively designed overviews of randomised trials. Blood Pressure Lowering Treatment Trialists' Collaboration. Lancet. 2000;356:1955-64.
  • Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560-72.
  • The Trials of Hypertension Prevention Collaborative Research Group. Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. Arch Intern Med. 1997;157:657-67.
  • Whelton PK, Appel LJ, Espeland MA, Applegate WB, Ettinger WH Jr, Kostis JB, et al. Sodium reduction and weight loss in the treatment of hypertension in older persons – A randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). JAMA. 1998; 279:839-46.
  • Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. for the DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 2001;344:3-10.
  • Vollmer WM, Sacks FM, Ard J, Appel LJ, Bray GA, Simons-Morton DG, et al. Effects of diet and sodium intake on blood pressure. Ann Intern Med. 2001;135:1019-28.
  • Chobanian AV, Hill M. National Heart, Lung, and Blood Instıtute Workshop on Sodium and Blood Pressure: a critical review of current scientific evidence. Hypertension. 2000;35:858-63.
  • Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK. Effects of alcohol reduction on blood pressure. Hypertension. 2001;38:1112-17.
  • Kelley GA, Kelley KS. Progressive resistance exercise and resting blood pressure. Hypertension. 2000;35:838-43.
  • Taylor-Tolbert NS, Dengel DR, Brown MD, McCole SD, Pratley RE, Ferrell RE, et al. Ambulatory blood pressure after acute exercise in older men with essential hypertension. Am J Hypertens. 2000;13(1Pt1):44-51.
  • World Health Organization. The Atlas of Heart and Stroke. Risk factor: blood pressure. Available from http://www.who.int/cardiovasculardiseases/en/cvd_atl as_05_HBP.pdf. Ogihara T, Kikuchi K, Matsuoka H, Fujita T, Higaki J, Horiuchi M, et al. Japanese Society of Hypertension. Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2009). Hypertens Res 2009; 32:3-107.
  • Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2003;42:878-84.
  • Mohammadi Ease, Abedi HA, Gofranipour F, Jalali F. Partnership caring: a theory of high blood pressure control in Iranian hypertensives. Int J Nurs Pract. 2002;8:324-29.
  • Kaplan NM. Clinic Hypertension. Tercüme: Canbek E. Klinik Hipertansiyon, Turgut yayıncılık, İstanbul. 2003; 1-550.
  • Zillich AJ, Haines ST. ASHP therapeutic position statement on the treatment of hypertension. Am J Health Syst Pharm. 2006;63:1074-80.
  • Hill MN, Miller NH. Compliance enhancement: a call for multidisciplinary team approaches. Circulation. 1996;93:4-6.
  • Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25:1105-87.
  • Nazaré J.Awareness, treatment and control of hypertension. Rev Port Cardiol. 2010;29:1793-7.
  • Aparcı M, Kardeşoğlu E, Yiğiner Ö, Özmen N, Cingözbay BY, Cebeci BS. Sosyoekonomik düzeyi farklı bölgelerde bulunan iki sağlık ocağında takip edilen hipertansiyon hastalarının tedaviye uyum süreci ve değişik özelliklerinin karşılaştırılması. TSK Koruyucu Hekimlik Bülteni. 2008; 7:333-8.
  • Eryonucu B, Sayarlıoğlu M, Bilge M, Guler N, Erkoc R, Dilek İ.Van ili yöresindeki hipertansif hastaların hipertansiyon konusundaki bilgi düzeylerinin ve tedaviye uyumlarının değerlendirilmesi. Van Tıp Dergisi. 1999;6:11-4.
  • Bailey BJ, Carney SL, Gillies AH, McColm LM, Smith AJ, Taylor M. Hypertension treatment compliance: what do patients want to know about their medication? Prog Cardiovasc Nurs. 1997;12:23
  • Kara B, Uzun Ş, Yokuşoğlu M, Uzun M. The effect of medicine knowledge on the methods applied for lowering blood pressure in patients with hypertension. TSK Koruyucu Hekimlik Bülteni. 2009; 8:231
  • Gögen S, Özdemir Y. Birinci Basamak Sağlık Kuruluşunda Hipertansif Hastaların Takibi. TSK Koruyucu Hekimlik Bülteni. 2005;4:8–15.
  • Yazışma Adresi / Address for Correspondence: Dr. Cenk Aypak Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Aile Hekimliği Kliniği ANKARA e-mail: cenkaypak@yahoo.com geliş tarihi/received :24.09.2012 kabul tarihi/accepted:02.11.2012

Hipertansif Hastaların Kan Basıncı Kontrol Düzeylerinin ve Tedavi Uyumlarının Değerlendirilmesi

Year 2013, Volume: 38 Issue: 2, 224 - 232, 01.06.2013

Abstract

Amaç: Bu çalışmada hipertansif hastaların, hipertansiyon (HT) hakkındaki bilgi düzeylerinin değerlendirilmesi, yaşam tarzı değişikliklerine uyumlarının saptanması ve antihipertansif tedavi altındaki kan basıncı düzeylerinin tespit edilmesi amaçlanmıştır. Yöntem: Bu kesitsel çalışmaya, Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Aile Hekimliği polikliniklerine 1 Şubat-30 Nisan 2012 tarihleri arasında ilk defa başvuran HT hastaları dahil edilmiştir. Hastalar, kan basıncı kontrolü başta olmak üzere tedavi hedeflerine ulaşma oranları ve bunları etkileyebilecek faktörler açısından değerlendirilmiştir. Bulgular: Çalışmaya 340 hasta dahil edildi. Hastaların yaş ortalaması 60,5±10,7 yıl olup 222"si (%65,3) kadındı. 108 (%31,8) hastanın kan basıncı kontrol altında değildi. Erkek hastaların ortalama vücut ağırlıkları kadın hastalara göre istatistiksel olarak fazlaydı (p=0,015). Normal tansiyon değerinin kaç olması gerektiğini bilen 249 (%73,2) hastanın, 155"i (%62,2) kadındı ve 179"u (%71,9) 65 yaşından gençti (p=0,0001). 41 (%12,1) hastanın halen sigara içmekte olduğu, 46 hastanın (%13,5) düzenli diyet yaptığı ve 32 hastanın (%9,4)"ünün düzenli egzersiz uyguladığı tespit edildi. Düzenli egzersiz yapan hasta grubunda kan basıncı kontrol oranı daha yüksekti (p=0,001). Erkek hastalarda düzenli diyet ve egzersiz yapma oranı kadınlara göre daha yüksekti (p=0,09). Hastaların ancak 86"sı (%25,3) kullandığı antihipertansif ilacın ismini bilmekte ve 65"i (%19,1) ilacının dozunu bilmekteydi. Kadın hastaların, erkek hastalara göre daha fazla oranda ilaçlarının adını bildiği tespit edildi (p=0,002). 156 hasta (%45,9) iki çeşit antihipertansif ilaç kullanmaktaydı. 58 hastanın (%17,1) haftada bir kaç defa doz atladığı öğrenildi. Sonuç: HT hastalarının, hastalıkları hakkındaki bilgi düzeyi ve ilaç dışı tedaviye uyumları yetersiz olup, güncel kılavuzlara göre geliştirilmiş bir hasta - hekim ilişkisi ile hasta uyumun arttırılmasına ihtiyaç vardır.

References

  • Danaei G, Finucane MM, Lin JK, Singh GM, Paciorek CJ, Cowan MJ et al. National, regional and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 4 million participants. Lancet. 2011;377:568
  • Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217–
  • Soydan İ: Hipertansiyon İle İlgili TEKHARF Çalışması Verileri ve Yorumları. In: Onat A (ed) TEKHARF: Türk Erişkinlerinde Kalp Sağlığı: Halkımıza İlişkin Temel Veri Üretiminden Evrensel Tıbba Katkıya. Argos Yayıncılık, İstanbul. 2005; 60
  • Centers for Disease Control and Prevention (CDC). Vital signs: prevalence, treatment, and control of hypertension—United States, 1999-2005 and 2005200 MMWR Morb Mortal Wkly Rep. 2011;60:103–
  • Llisterri Caro JL, Rodríguez Roca GC, Alonso Moreno FJ, et al. Control of blood pressure in Spanish hypertensive population attended in primary health-care. PRESCAP 2006 Study. Med Clin (Barc). 2008;130:681–7.
  • Llisterri Caro JL, Rodríguez Roca GC, Alonso Moreno FJ, Banegas Banegas JR, González-Segura Alsina D, Lou Arnal S, et al. Prevalence, awareness, treatment and control of hypertension in Portugal: The PAP study. J Hypertens. 2005;23:1661-6.
  • Altun B, Arici M, Nergizoğlu G, Derici U, Karatan O, Turgan C, Sindel S, et al. Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens. 2005;23:1817
  • Oliveria SA, Chen RS, McCarthy BD, Davis CC, Hill MN. Hypertension knowledge, awareness, and attitudes in a hypertensive population. J Gen Intern Med. 2005;20:219-25.
  • Whitworth JA. World Health Organization, International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/International
  • Society of Hypertension (ISH) statement on management of hypertension. J Hypertens. 2003;21:1983-92.
  • Psaty BM, Smith NL, Siscovick DS, Koepsell TD, Weiss NS, Heckbert SR, et al. Health outcomes assocaited with antihypertensive therapies used as first-line agents. JAMA. 1997;277:739-45.
  • Stamler J, Stamler R, Neaton JD. Blood pressure, systolic and diastolic, and cardiovascular risks: US population data. Arch Intern Med. 1993;153:598-615.
  • Kannel WB, Dawber TR, Kagan A, Revotskie N, Stokes J 3rd. Factors of risk in the development of coronary heart disease–six year follow-up experience. The Framingham study. Ann Intern Med. 1961;55:33-50.
  • Neal B, MacMahon S, Chapman N. Effects of ACE inhibitors, calcium antagonists, and other bloodpressure-lowering drugs: results of prospectively designed overviews of randomised trials. Blood Pressure Lowering Treatment Trialists' Collaboration. Lancet. 2000;356:1955-64.
  • Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560-72.
  • The Trials of Hypertension Prevention Collaborative Research Group. Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. Arch Intern Med. 1997;157:657-67.
  • Whelton PK, Appel LJ, Espeland MA, Applegate WB, Ettinger WH Jr, Kostis JB, et al. Sodium reduction and weight loss in the treatment of hypertension in older persons – A randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). JAMA. 1998; 279:839-46.
  • Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. for the DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 2001;344:3-10.
  • Vollmer WM, Sacks FM, Ard J, Appel LJ, Bray GA, Simons-Morton DG, et al. Effects of diet and sodium intake on blood pressure. Ann Intern Med. 2001;135:1019-28.
  • Chobanian AV, Hill M. National Heart, Lung, and Blood Instıtute Workshop on Sodium and Blood Pressure: a critical review of current scientific evidence. Hypertension. 2000;35:858-63.
  • Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK. Effects of alcohol reduction on blood pressure. Hypertension. 2001;38:1112-17.
  • Kelley GA, Kelley KS. Progressive resistance exercise and resting blood pressure. Hypertension. 2000;35:838-43.
  • Taylor-Tolbert NS, Dengel DR, Brown MD, McCole SD, Pratley RE, Ferrell RE, et al. Ambulatory blood pressure after acute exercise in older men with essential hypertension. Am J Hypertens. 2000;13(1Pt1):44-51.
  • World Health Organization. The Atlas of Heart and Stroke. Risk factor: blood pressure. Available from http://www.who.int/cardiovasculardiseases/en/cvd_atl as_05_HBP.pdf. Ogihara T, Kikuchi K, Matsuoka H, Fujita T, Higaki J, Horiuchi M, et al. Japanese Society of Hypertension. Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2009). Hypertens Res 2009; 32:3-107.
  • Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2003;42:878-84.
  • Mohammadi Ease, Abedi HA, Gofranipour F, Jalali F. Partnership caring: a theory of high blood pressure control in Iranian hypertensives. Int J Nurs Pract. 2002;8:324-29.
  • Kaplan NM. Clinic Hypertension. Tercüme: Canbek E. Klinik Hipertansiyon, Turgut yayıncılık, İstanbul. 2003; 1-550.
  • Zillich AJ, Haines ST. ASHP therapeutic position statement on the treatment of hypertension. Am J Health Syst Pharm. 2006;63:1074-80.
  • Hill MN, Miller NH. Compliance enhancement: a call for multidisciplinary team approaches. Circulation. 1996;93:4-6.
  • Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25:1105-87.
  • Nazaré J.Awareness, treatment and control of hypertension. Rev Port Cardiol. 2010;29:1793-7.
  • Aparcı M, Kardeşoğlu E, Yiğiner Ö, Özmen N, Cingözbay BY, Cebeci BS. Sosyoekonomik düzeyi farklı bölgelerde bulunan iki sağlık ocağında takip edilen hipertansiyon hastalarının tedaviye uyum süreci ve değişik özelliklerinin karşılaştırılması. TSK Koruyucu Hekimlik Bülteni. 2008; 7:333-8.
  • Eryonucu B, Sayarlıoğlu M, Bilge M, Guler N, Erkoc R, Dilek İ.Van ili yöresindeki hipertansif hastaların hipertansiyon konusundaki bilgi düzeylerinin ve tedaviye uyumlarının değerlendirilmesi. Van Tıp Dergisi. 1999;6:11-4.
  • Bailey BJ, Carney SL, Gillies AH, McColm LM, Smith AJ, Taylor M. Hypertension treatment compliance: what do patients want to know about their medication? Prog Cardiovasc Nurs. 1997;12:23
  • Kara B, Uzun Ş, Yokuşoğlu M, Uzun M. The effect of medicine knowledge on the methods applied for lowering blood pressure in patients with hypertension. TSK Koruyucu Hekimlik Bülteni. 2009; 8:231
  • Gögen S, Özdemir Y. Birinci Basamak Sağlık Kuruluşunda Hipertansif Hastaların Takibi. TSK Koruyucu Hekimlik Bülteni. 2005;4:8–15.
  • Yazışma Adresi / Address for Correspondence: Dr. Cenk Aypak Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Aile Hekimliği Kliniği ANKARA e-mail: cenkaypak@yahoo.com geliş tarihi/received :24.09.2012 kabul tarihi/accepted:02.11.2012
There are 37 citations in total.

Details

Primary Language Turkish
Journal Section Research
Authors

Cenk Aypak This is me

Özde Önder This is me

Murat Dicle This is me

Hülya Yıkılkan This is me

Hasan Tekin This is me

Süleyman Görpelioğlu This is me

Publication Date June 1, 2013
Published in Issue Year 2013 Volume: 38 Issue: 2

Cite

MLA Aypak, Cenk et al. “Hipertansif Hastaların Kan Basıncı Kontrol Düzeylerinin Ve Tedavi Uyumlarının Değerlendirilmesi”. Cukurova Medical Journal, vol. 38, no. 2, 2013, pp. 224-32.