Hypertension and Spurious Systolic Hypertension in Youth

Abstract

Introduction: The integrated out-patient management of the Heart Failure (HF) seems to constitute a winning approach to this condition, even if its effects in the clinical practice are nevertheless object of discussion. Objectives: Purpose of this study has been that to appraise the variations of the NYHA class and of ejection fraction (EF%) after 12 months of integrated out-patient management in a population of hypertensive patient (pts) affected from HF. Methods: 220 pts with HF (defined according to the criteria suggested by the ACC/AHA guidelines) have been inserted in a comprehensive program of integrated management of educational intervention on the patient himself and on the family. A clinical evaluation, with determination of the class NYHA and echocardiography evaluation with determination of the EF%, have been performed both at the entry of the study and after 12 months. The variation of the risk to develop a fatal event has been evaluated with the COX model. Results: 160 pts (72,7%, average age 72,9% years) presented EF> 45% (group 1) and 60 pts (27,3%, average age 74,6) presented FE < = 45% (group 2). In group 1 EF% was 61,5 ±8 at the basal measurement and 62±8 after 12 months (ns) while in group 2 EF was 35±6 at the basal one and 46,6 ±13after 12 months (p < 0.002). There is a 10% of risk reduction for every 1% of EF increment (RR=0,90; 0,84-0,96: p < 0,001). The variations of NYHA class is reassumed in the chart (for the trend in improvement: p < 0,001, FE < = 45%; p < 0,0001, FE > 45%) [see table]. NYHA I NYHA II NYHA III NYHA IV basal 12 months basal 12 months basal 12 months basal 12 months FE ≤45% 6,7% 30% 65% 55% 28,3% 10% 0% 5% FE >45% 46,9% 65,5% 40% 33,3% 13,1% 1,4% 0% 0% Conclusions:The ambulatory integrated management has independently allowed an improvement of the clinical conditions of the pts with HF independently from the presence or absence of systolic dysfunction and an improvement of the EF% in the pts with systolic dysfunction, with benefit effect also on the correlated events to the same HF.

Assessing the Role of Knowledge, Awareness, Practice in Achieving Medication Adherence among Hypertensive Patients

“…[1] Hypertension is a condition within which the pressure of the blood is chronically elevated. [2][3][4] Hypertension can lead to cardiovascular morbidity and mortality ensuing from target-organ damage to blood vessels in the heart, brain, kidney and eyes . [5] It has also been recognized that adherence to Antihypertensive drugs (AHD) is an important mediator of achieving desirable BP management, however poor adherence with medication still remains a problem among hypertensive patients.…”

ECHOs of Medication Non-Adherence in Hypertensive Patients: A Systematic Review

“…If the underlying comorbidities are corrected, blood pressure could return to normal. [1] It is known as silent killer in developed and developing nations. [2] More than 26% of the adult populations worldwide have been diagnosed to have hypertension.…”