Guidelines that are just for guidance
Published on: 9th April, 2018
OCLC Number/Unique Identifier: 7671836090
Hypertension (HTN) is a widely prevalent disease across the globe. Recent reports from National Health and Nutrition Examination Surveys (NHANES) indicate that the prevalence of HTN is 29% in adults more than 18 years in the US [1]. This is about 72 million adults. Worldwide, about 1.3 billion people are affected by HTN [2]. This number is projected to increase several-fold in the coming years. Given the huge burden of this disease to the healthcare system and the many deleterious effects that can result from uncontrolled HTN, we need strong guidelines to manage the same. The recently published 2017 ACC/AHA guidelines [3] on hypertension management are very meticulous and include a comprehensive stepwise approach in treating hypertension. Here we present a summary of the major changes and a concise review of the new guidelines.
Comparison of Efficacy and Safety of Hydroxychloroquine and Teneligliptin in Type 2 Diabetes Patients who are Inadequately Controlled with Glimepiride, Metformin and Insulin therapy: A Randomized Controlled Trial with Parallel Group Design
Published on: 13th September, 2018
OCLC Number/Unique Identifier: 7856189396
Aim: The aim of the present study is to assess the efficacy and safety of Hydroxychloroquine in comparison with Teneligliptin in type 2 diabetes patients whose blood glucose levels were inadequately controlled with metformin, Glimepiride and insulin therapy.
Methods: This was a randomized, prospective, parallel-group, experimental trial done in 300 Type 2 Diabetes patients who were uncontrolled (HbA1c=7.5–10%) with metformin, Glimepiride and insulin therapy. Patients were randomly divided into two groups one received Teneligliptin 20 mg (n=152) and other received Hydroxychloroquine 400 mg (n=148) while continuing insulin therapy with other 2 OHA. Insulin doses were adjusted to maintain normal blood glucose levels.
Result: The adjusted mean change from baseline to endpoint in HbA1c was −1.2±0.5% in patient group receiving Hydroxychloroquine and −0.9±0.5% in patients group receiving Teneligliptin, respectively, with a significant between-treatment difference (p<0.001). The incidence of adverse events was similar in the Hydroxychloroquine (72%) and Teneligliptin (77%) groups. However, hypoglycaemic events were less common (p<0.001) and less severe (p<0.05) in patients receiving Hydroxychloroquine than in those receiving Teneligliptin.
Conclusion: Hydroxychloroquine decreases HbA1c in patients whose type 2 diabetes is poorly controlled with high doses of insulin as compare to Teneligliptin. Addition of hydroxychloroquine to insulin therapy is also associated with reduced incidence of confirmed and severe hypoglycaemia.
Cardiovascular risk reduction: Past, present and future in Mexico
Published on: 17th July, 2018
OCLC Number/Unique Identifier: 7815004265
Atherosclerotic cardiovascular disease (ASCVD) is globally defined as coronary heart disease, cerebrovascular disease, or peripheral arterial disease presumed to be of atherosclerotic origin and it is the leading cause of morbidity and mortality for individuals with or without diabetes and is the largest contributor to the direct and indirect catastrophic costs of cardiovascular disorder. Very common conditions coexisting into the cardiovascular risk (e.g., obesity, hypertension, diabetes and dyslipidemia) are clear risk factors for ASCVD, and diabetes itself confers independent risk. Numerous studies have shown the efficacy of controlling individual cardiovascular risk factors in preventing or slowing ASCVD in people with these disorders. In other words it is not enough control one risk factor. We need to develop novel strategies to detect and control all of them at the same time. Thus, large benefits are seen when multiple cardiovascular risk factors are addressed simultaneously. Under the current paradigm of aggressive risk factor modification in patients with cardiovascular risk, there is evidence that measures of 10-year coronary heart disease (CHD) risk among U.S. adults with cardiovascular risk have improved significantly over the past decade and that ASCVD morbidity and mortality have decreased. In Mexico the Mexican Institute of Social Security is implementing new strategies of primary and secondary prevention in order to confront this pandemic.
In this review, we analyze the state of the art to approach at the same time the different cardiovascular risk factors, in an integral form because of this is the real worldwide challenge of health.
Endocrine abnormalities in two siblings with Rothmund Thomson Syndrome
Published on: 11th October, 2018
OCLC Number/Unique Identifier: 7906107605
Rothmund-Thomson syndrome is a rare autosomal recessive disorder characterized by poikiloderma (skin atrophy, telangiectasia, hyper- and hypopigmentation), congenital skeletal abnormalities, short stature, premature aging, and increased risk of malignant disease. Two siblings with Rothmund-Thomson Syndrome showed the following characteristic features: severe growth failure, dystrophic nails, absent eyelashes/eyebrows, small hands, clinodactyly, microdontia and congential poikiloderma. In addition, delayed sexual development with cryptorchidism in the male and Hashimato thyroiditis in the female patient were detected. These cases are presented here because of these endocrine patterns, with the aim of drawing attention to the invisible aspects of Rothmund-Thomson syndrome.
Role of the Kidneys in the Regulation of Intra-and Extra-Renal Blood Pressure
Published on: 17th July, 2018
OCLC Number/Unique Identifier: 7814987529
Hypertension is one of the most common chronic diseases of human, affecting more than one billion people worldwide. When it becomes chronic, hypertension leaves behind cardiac hypertrophy, heart failure, stroke, and kidney disease, resulting in substantial morbidity and mortality. Treatments that effectively reduce blood pressure can prevent these complications. Abnormalities in the production of urine by the kidneys have been implicated in increased vascular resistance, leading to high blood pressure and increased cardiac mass. By matching urinary excretion of salt and water with dietary intake, balance is usually attained, thereby maintaining a constant extracellular fluid volume and blood pressure. Based on the capacity for the kidney to excrete sodium, this blood pressure-altering mechanism should have sufficient advantage to limit intravascular volume and consequently lower blood pressure in response to a range of stimuli from elevated heart rate to increase peripheral vascular resistance. A major determinant of the level of intra- and extra- renal blood pressure is therefore sodium handling, and it is controlled by complex physiological mechanism by hormones, inflammatory mediators, and the sympathetic nervous system. Homoeostasis and favourable influence sodium balance are a basic mechanism of efficacy for diuretics and dietary sodium restriction in hypertension. Renin Angiotensin System (RAS) inhibitors, vasodilators, and β-blockers work to facilitate pressure-natriuresis. Also, WNK signaling pathways, soluble inflammatory mediators, and pathways regulating extra-renal sodium disposition may be the focus towards elimination of sodium and reducing blood pressure in hypertension.
Could metabolic risk factors contribute to the development of cervical cancer?
Published on: 18th December, 2019
OCLC Number/Unique Identifier: 8501565253
The role of human papillomavirus infection as etiological factor for cervical squamous intraepithelial lesions and cervical cancer is well established. However, the presence of this virus is not sufficient condition for developing of cervical cancer. Currently, the contribution of other viral, environmental and host cofactors in triggering of this neoplasm is being investigated. Some metabolic risk factors have been associated with the development of several gynecological cancers such as endometrium, ovary and cervix. However, the mechanisms through which these factors contribute to carcinogenesis are complex and not fully elucidated. Few interventions regarding host metabolic factors have been performed on women at risk of developing cervical cancer. Some specific treatments and or changes in lifestyles could be carried out to avoid or delay progression to this kind of cancer. This paper aims to enlarge and update this topic based on the article ¨Association between components of the metabolic syndrome and degree of cervical squamous intraepithelial lesions in Cuban women¨, with emphasis on possible mechanisms that explain the link between central adiposity, insulin resistance and dyslipidemia with risk of premalignant lesions and cervical cancer.
What is the Cost of Measuring a Blood Pressure?
Published on: 11th October, 2018
OCLC Number/Unique Identifier: 7893702194
Rationale: Blood Pressure measurement has transitioned to the oscillometric method in most hospitals in the United States, however out-patient offices mainly use the auscultatory technique.
Objective: To determine time taken to measure blood pressure by an automatic oscillometric device compared to an auscultatory measurement device and to determine what each measurement costs.
Methods: Blood Pressures were measured in a single primary care office by medical assistants (MA) for patients seen for office visits. Timed measurements were performed using an automated oscillometric Welch Allyn Connex Vital Signs Monitor (WA) and manually using a Tycos device. A minimum of 400 readings were taken with each method.
Results: The average time to manually measure BP was 58.6 seconds, whereas the WA average was 39.8 seconds, 18.8 seconds faster (p<0.05). There was an improvement in measurement time with MA experience with the WA device (p<0.05). The average MA cost to measure a single BP using the manual method was $0.35 vs. the WA method ($0.24) or a savings of $0.11 per measurement. The improvement with experience of WA method reduced cost to $0.17 per measurement.
Conclusion: The oscillometric method saved 17cents per measurement potentially saving $1,119 per year for our primary care practice.
Strategic Plans for Diagnosis, Treatment & Control of Hypertension
Published on: 23rd November, 2018
OCLC Number/Unique Identifier: 7943259097
Two major challenges face the practicing physicians and medical community regarding the management of hypertension. First is accurate diagnosis and finding who is the truly hypertensive patient in need of life-long treatment. Second is to improve blood pressure control through addressing hypertension risk factors, adherence to treatment and frequent monitoring.
- Current Challenges in Management
o Accurate diagnosis of hypertension
o Improving blood pressure control
- What Do We Need For The Future?
Heart Failure with preserved Ejection Fraction (HFpEF); A Mexican cohort from Mexican Institute of Social Security (IMSS)
Published on: 28th January, 2019
OCLC Number/Unique Identifier: 7991667293
Background: Several epidemiologic studies indicate that up to 50% of patients with heart failure have a preserved ejection fraction, and this proportion has increased over time. The knowledge of its severity and associated comorbidity is determining factor to develop adequate strategies for its treatment and prevention. This study was focus on the creation of a cohort and follow-up of Mexican population and to analyze its severity as well as its interaction with the comorbidity of other cardiovascular risk factors.
Methods: We included patients from different sites of Mexico City than were sent to the Cardiology hospital of the National Medical Center in Mexico City for the realization of an echocardiogram as part of their assessment by the presence of dyspnea, edema, or suspicion of hypertensive heart disease. Complete medical history, physical examination and laboratory studies including Brain Natriuretic Peptide (BNP) serum levels were performed. Diagnosis of diastolic dysfunction was based on symptoms and echocardiographic data including time of deceleration, size of left atrium, e´ septal and e´ lateral, as well as E wave, A wave and its ratio E/A. All patients had left ventricle ejection fraction > 45%.
Results: We included 168 patients with HFpEF. The most common risk factor was hypertension (89.2%), followed by overweight and obesity (> 78.5%), dyslipidemia (82.1%) and diabetes (42.8%). Women were dominant, 108 (64.3%); the mean age was 63 years old. When we classify by severity of diastolic dysfunction, we found that 41.1% were grade I, 57.1% were grade II and only 1.8% were grade III. The risk factors most strongly associated with the severity of diastolic dysfunction were hypertension, obesity and dyslipidemia. We found BNP levels highly variables, but the levels were higher detected as the ejection fraction was approaching to 45%. At one year of follow up mortality was not reported.
Conclusion: HFpEF is a frequent entity in patients with cardiovascular risk factors in Mexico. The most common risk factor was hypertension. The combination of hypertension, overweight and dyslipidemia predicted the severity of diastolic dysfunction. We recommend that all Mexican patient with hypertension and overweight or obesity should be submitted as a part of its medical evaluation to an echocardiogram study in order to detect diastolic dysfunction even though the signs or symptoms are or not evident.
Type 2 diabetes and cancer
Published on: 28th February, 2020
Diabetes mellitus increases the possibility of different cancers. Scientists have substantiated the link of diabetes with increased prevalence, augmented progression and improved cancer aggression. Research has strengthened link of diabetes with the colorectal cancer risk among various cancers. Diagnosis and treatment have made some progress in recent years, but Colorectal is major issue for the health of people even today. In order to reduce cancer mortality, there is importance of prophylaxis, evaluation and proper treatment. Factors distressing cancer prognosis is required by policy-making system for beneficial approaches of cancer patients and improvement of disease. Eventually diabetes- specific strategies for different cancers are explored.
Hypertension as a persistent public health problem. A position paper from Alliance for a Healthy Heart, Mexico
Published on: 3rd April, 2019
OCLC Number/Unique Identifier: 8062251564
Today, Mexico has more than 130 million inhabitants; 85 millions of them are adults of 20 or more years old. The population pyramid is still one of base wider and this base corresponds to adults younger than 54 years old. Despite predictions made 20 years ago, about a transformation of the population pyramid shape to a mushroom shape as a consequence of more life expected and adult population growth; this change has not been occurred. Hypertension has become the biggest challenge of noncommunicable chronic diseases to public health in Mexico. Around 30% of adult Mexican population has hypertension; 75% of them have less than 54 years old (in productive age); 40% of them are unaware but only 50% of aware hypertensive population takes drugs and, 50% of them are controlled (< 140/90 mmHg). Cardiovascular risk factors including hypertension, dyslipidemia, obesity, and diabetes often cohabit in the same person and are magnified one to another in terms of common pathophysiological pathways. Atherosclerosis, arrhythmias, stroke and heart failure are common and are the final pathologic end-points and explains why cardiovascular diseases occupy first place in mortality in Mexico and worldwide. The costs of care for these diseases are billionaires and if we do not generate appropriate strategies, their global impact can become a high threat to social development of the country. The life style like nutrition, sports habits of the Mexicans must be emphasized; there is poor education about this crucial topic. This position paper is focused on the principal controversies and strategies to be developed by all, government, society, physicians, nurses, patients and all people related with healthcare of hypertension, in order to confront this huge public health problem in Mexico.
Circulating platelet-derived vesicle in atrial fibrillation
Published on: 27th June, 2019
OCLC Number/Unique Identifier: 8195602066
Platelet vesiculation is common factor contributing in coagulation and thromboembolism in patients with atrial fibrillation (AF). Platelet-derived vesicles are involved in the coagulation, thromboembolism, microvascular inflammation, arterial stiffness, vascular calcification, atherosclerotic plaque shaping and rupture, endothelial dysfunction, cardiac remodelling, and kidney dysfunction. Recent clinical studies have revealed elevated concentrations of platelet-derived vesicles in peripheral blood of patients with current AF and history of AF. The aim of the mini review is to discuss the role of platelet-derived micro vesicles as predictive biomarker in AF. Serial measures of circulating levels of platelet-derived vesicules are discussed to be useful in stratification of AF patients at risk of thromboembolic complications, but there is limiting evidence regarding their predictive value that requires further investigations in large clinical trials.
Diagnostic imaging in congenital adrenal hyperplasia – how does it help?
Published on: 29th April, 2020
OCLC Number/Unique Identifier: 8586055620
The phenotypic manifestation of congenital adrenal hyperplasia (CAH) is variable, and this largely depends on the extent of 21-Hydroxylase enzyme deficiency. In non- classic CAH (NCCAH), the clinical features predominantly reflect the androgen excess rather than adrenal insufficiency. In boys, the condition may not present until much later in childhood, where the diagnosis is made following presentation with precocious puberty, features of aldosterone insufficiency, or this condition may be detected during fertility workup Imaging is generally not used in the evaluation of CAH, but may be helpful for the diagnosis, management, and follow-up of these patients. CAH can result in adrenal enlargement in both classic and non-classic forms of adrenal hyperplasia. The so-called adrenal rest tissue may be seen at several sites throughout the body, including the celiac plexus region, broad ligaments, normal ovaries, and testes. Sustained elevation of adrenocorticotropic hormone (ACTH) in patients with CAH has been postulated to cause adrenal rest cells to grow and become functionally active. The discovery of bilateral adrenal enlargement during radiologic evaluation for unrelated disease processes might serve as a mode of presentation for clinically not apparent or non- classical congenital adrenal hyperplasia (NCCAH).
The New (2018) European Hypertension Guidelines an overview & comments
Published on: 24th July, 2019
OCLC Number/Unique Identifier: 8207879134
The European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) jointly developed a series of hypertension guidelines in the years 2003, 207 and 2013. The most recent guidelines were issued by the two societies in August this year (2018) and were published in the European Heart Journal. The new guidelines are printed in more than 90 pages and cover almost all aspects of hypertension based on extensive review of literature giving highest priority to data from randomized controlled trials and well conducted meta-analysis. In important areas where there is inadequate or no evidence, guidelines authors resort to expert opinion. The text was developed over approximately 24 months and was reviewed by representatives of ESC and ESH national hypertension societies. Although it is less than five years since the last hypertension European guidelines in 2013, the recent 2018 guidelines show important differences in diagnosis and treatment strategies with the addition of new sections and recommendations on management of hypertensive emergencies, hypertension in women and pregnancy, different ethnic groups, chronic obstructive pulmonary disease, cancer therapies, peri-operative management, sexual dysfunction and perioperative management.
Validation of the Omron HBP-9031C blood pressure monitor for clinics and hospitals according to the ANSI/AAMI/ISO 81060-2:2013 protocol
Published on: 13th August, 2019
OCLC Number/Unique Identifier: 8207850026
Objective: The present study aimed to evaluate the accuracy of the Omron HBP-9031C automated oscillometric upper-arm blood pressure (BP) measurement device for blood pressure monitoring, according to the ANSI/AAMI/ISO 81060-2:2013 protocol (ANSI/AAMI/ISO).
Participants and Method: The device evaluations were performed in 85 participants, who fulfilled the inclusion criteria of the protocol. The validation procedure and data analysis followed the protocol precisely.
Results: In the ANSI/AAMI/ISO 81060-2-2013 validation procedure (criterion 1), the mean ± SD of the differences between the test device and reference BP was 0.5 ± 7.84/-1.9 ± 6.30 mmHg (systolic/diastolic). The mean differences between the two observers and the Omron HBP-9031C were 0.5 ± 6.69 mmHg (range, −18 to 15 mmHg) for systolic BP and -1.9 ± 5.63 mmHg (range, −17 to 14 mmHg) for diastolic BP, according to criterion 2. The two criteria of the ANSI/AAMI/ISO were fulfilled.
Conclusion: The professional OMRON BP monitor, HBP-9031C fulfilled the requirements of the ANSI/AAMI/ISO validation standard and can be recommended for clinical use.
Compliance of hypertensive patients with antihypertensive drug therapy at the Renaissance Hospital of N’Djamena, Chad
Published on: 23rd October, 2019
OCLC Number/Unique Identifier: 8301372454
Introduction: High blood pressure is a major cardiovascular risk factor. In hypertension, non-compliance is frequent. The objective of this work is to evaluate the therapeutic observances and to identify the predictive factors of poor compliances in Chadian hypertensive patients.
Patients and Methods: It was a prospective cross-sectional study over a six-month period from January 15 to July 15, 2019. This was performed in the outpatient Cardiology and Nephrology units at the Renaissance Hospital of N’Djamena. We included all follow-up patients who had hypertension who consulted during the study period. However, dialysis patients and children were excluded from this study. The parameters studied were demographic characteristics, economic and therapeutic data and the rate of therapeutic compliance.
Results: Eighty-seven patients were included. The average age was 50 years old. The sex ratio was 2.5. Sixty-seven percent (n = 58) of the patients were from urban areas. The predominant cardiovascular risk factors were smoking in 25% (n = 22) and diabetes in 23% (n = 20). Hypertension was uncontrolled in 76% (n = 66) patients. Adherence was poor in 66% (n = 57) of patients. The monthly cost of treatment was respectively 10,000 and 20,000 FCFA in 52% (n = 45) of cases. Combination therapy was observed in 70% of cases (n = 61) and 56% (n = 49) of patients had more than one drug intake. The adherence rate was 93% (n = 28) in the urban population (p < 0.001). All patients (n = 30) who were observing their treatment were educated (p < 0.001). The adherence rate was 20% (n = 6) in patients who had a monthly income less than 100,000 FCFA (p = 0.004). The adherence rate was 60% (n = 18) when the monthly cost was less than FCFA 10,000 (p = 0.003). The adherence rate was 77% (n = 23) in patients receiving monotherapy (p < 0.001).
Conclusion: This study showed a low level of adherence in Chadian hypertensive patients. The complexity and cost of antihypertensive therapy, poor knowledge of hypertension, and ignorance of its severity have been the main factors of poor compliance.
Incidence of hypertension in a high-risk workgroup (Police officers) - Observational study
Published on: 8th November, 2019
OCLC Number/Unique Identifier: 8333010066
Introduction: Hypertension is a silent pathology in a way that affects all four spheres to be considered as such; magnitude, transcendence vulnerability, and feasibility. The World Health Organization estimates that 45% of deaths from heart disease and 51% of deaths from stroke globally are caused by hypertension.
Material and method: A longitudinal, descriptive and quantitative observational study was carried out on the personnel of high-risk public service providers.
Results: The total population sampled was 550 people where it was possible to determine the sex where the disease predominates, since 92% of the hypertensive population belong to the male sex, while 8% of the female population. 57% of the total population were classified as normotensive, while 21% were classified as High Normal, Grade I Hypertension, and Grade II Hypertension.
Discussion: AHT is the result of a series of interactions between endogenous and exogenous factors in an organism that tries to adapt to the increase of the cardiac output and the peripheral resistance of the blood vessels, which is manifested by the increase in blood pressure figures. Physical activity has been shown to have a lower risk of hypertension compared to sedentary individuals. The daily stress these workers face predisposes them to suffer their manifestations as headache, muscle pain, fatigue, digestive disorders and constant elevations of blood pressure.
Silent cerebrovascular disease in hypertensive adults is frequent and age-dependent
Published on: 13th August, 2020
OCLC Number/Unique Identifier: 8677986450
Background: Cerebral small vessel disease and extracranial atherosclerotic carotid disease are manifestations of silent cerebrovascular disease (CVD). Information on these two pathologies in hypertensive population with low cardiovascular risk (CVR) is scarce.
Objective: To explore frequency and characteristics of silent CVD in hypertensive adults and cognitive repercussion of these alterations.
Methods: 39 hypertensive patients (mean age: 53.5 years) were studied. Cerebral magnetic resonance imaging (3T), doppler ultrasound of the carotid artery and neuropsychological studies were obtained.
Results: 79% of patients presented white matter lesions (WML), 18% showed only cerebral atrophy and/or enlarged perivascular spaces, 60% presented hyperplasia of intimal media complex (IMC) and/or atheroma plaques. In women, a significant correlation was observed between IMC thickness and bifrontal index, and WML was greater in patients with carotid plaques. A non-significant decrease in neuropsychological performance was observed in the groups of patients with intra and/or extracerebral injury and a negative correlation with the bifrontal index in men was found.
Conclusion: Frequency of intra and extracerebral silent CVD was high in hypertensive adults with low to moderate CVR. WML and brain atrophy were partially related with carotid lesions. Age significantly influenced the appearance of intra and extracerebral lesions. Cognitive performance did not decrease significantly due to the presence of these lesions.
Detection of hypertension and its associated factors among Dessie Town Government School Staffs, Amhara Region, Dessie, Ethiopia, 2019
Published on: 29th September, 2020
OCLC Number/Unique Identifier: 8677986989
Introduction: Hypertension is the leading remediable risk factor for cardiovascular disease, affecting more than 1 billion people worldwide, and is responsible for more than 10 million preventable deaths globally each year. Hypertension can be described as the ‘Sleeping snake’, which bites when it wakes up.
Objectives: To detect hypertension and its associated factors among staffs of Dessie town government schools from December 10, 2018 to February 15, 2019 G.C.
Methods and materials: An institution-based cross-sectional study design was conducted among 225 Dessie town government school staffs whose age of 35 years and above. Systematic random sampling technique to select sample size of participants. Data was cleaned manually, coded and entered into Epi-info and analyzed by SPSS version 22 software. Multivariable logistic analysis AOR, 95% CI and p - value < 0.05 was used to identify variables which have significant association.
Results: From the total of 225 study participant’s 31(13.8%) of them diagnosed with hypertension. Multivariable logistic analyses had shown that 1st degree holders AOR (CI) = 3.05 [0.91,13.43], source of information from news AOR(CI) = 2.1 [0.816, 4.89], being protestant in religion AOR (CI) = 5.65 [0.74, 42.86], age from 41-60 years AOR (CI) = 1.96 [0.18,18.90], being divorced AOR (CI) = 2.35 [0.91,5.84], and teachers AOR (CI) = 3.4 [1.2, 9.825] maintain their significant association with detection of hypertension.
Conclusion and Recommendation: From this study significant numbers of respondents have hypertension. Educational status, source of information, marital status, occupation, religion and age of respondents were predictors for the occurrence of hypertension. Newly diagnosed hypertension on this was high among government school staffs which have no information about their blood pressure; which shows there was poor coverage of health screening.
Knowledge, attitude and practice towards hypertension among patients receiving care in a Nigerian Hospital
Published on: 29th September, 2020
OCLC Number/Unique Identifier: 8677986597
Background: Poor knowledge about hypertension can lead to poor attitude towards the disease which may directly affect patients self-care practices towards hypertension.
Objective: This study aimed to assess the knowledge, attitude and practice towards hypertension of hypertensive patients receiving care in Kogi state Specialist hospital, Lokoja, Kogi state Nigeria.
Methods: This was a cross sectional study conducted among Hypertensive patients receiving care in the Kogi State Specialist Hospital in Lokoja, Kogi state. All hypertensive patients visiting the Kogi State Specialist Hospital during the period of study and have given consent were allowed to participate in the study. A well designed questionnaire was used to collect patients soci-demographic and clinical variables. Also, a validated questionnaire was used to assess patients Knowledge, attitude and practice towards hypertension. Data were analysed using the Statistical Package for Social Sciences (SPSS for windows, Version 16.0. SPSS Inc. 2007.Chicago, USA) software. Continuous data were presented as mean± standard deviation while categorical data were presented as percentages and frequencies. Chi square and correlation test was also used to examine association between the variables in the data collected.
Results: A majority of the patients were aged 46-55 years 89 (27.5%), while almost half of the patients were males 161 (54.6%). About half of the patients 141 (43.5%) were selfemployed while a majority of the patients had at least a tertiary education 173 (53.4%). Only 4 (1.2%) of the patients reported that they had no formal education. About 60% of the patients reported to have had hypertension for 6-10 years while only 170 (57.4%) of the patients reported not to have any family history of hypertension. Also, only half of the patients 164 (50.6%) had their blood pressure controlled. Only one quarter of the patients had good knowledge and attitude towards hypertension. Also, only 4 (1.3%) patients had a good practice towards hypertension. There is a significant positive correlation between knowledge and attitude (r = 0.287, p < 0.001). Also, there is a fair positive correlation between Knowledge and practice (r = 0.254, p =
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