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1.
Vasc Health Risk Manag ; 15: 551-558, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31853180

RESUMO

Introduction: As hypertension is a chronic cardiovascular disease that contributes to a high proportion of morbidity and mortality worldwide, favorable knowledge is crucial to control it. Objective: The 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. Methods: An 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. Results: A 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. Conclusion: In 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.


Assuntos
Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Conhecimentos, Atitudes e Prática em Saúde , Estilo de Vida Saudável , Hospitais Universitários , Hipertensão/terapia , Ambulatório Hospitalar , Comportamento de Redução do Risco , Adulto , Idoso , Estudos Transversais , Escolaridade , Etiópia , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Ocupações , Fatores de Risco , Fatores Sexuais
2.
Nihon Yakurigaku Zasshi ; 154(5): 270-274, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31735757

RESUMO

In the 18th century, Edward Jenner proposed the vaccine for smallpox as a first vaccine therapy based on the legend that a vaccinia prevents the infection with smallpox. Recently, the therapeutic target of vaccine will expand from infectious diseases to various diseases, such as amyloid ß or tau vaccine for Alzheimer's disease. We are now going to develop a therapeutic vaccine to lifestyle-related diseases (i.e. high blood pressure), and aim to realize a novel therapy which will be injected once or twice per year from a daily medication. For this purpose, the appropriate choice of an antigen, carrier and adjuvants should be required to activate hormonal immunity by the vaccine, leading to efficient antibody production without toxicity, because the therapeutic target of our vaccine is an endogenous protein (i.e. hormone). The clinical advantage of this therapeutic vaccine is to improve the medical adherence and drug management because the multiple drug users are increased in particular old patients, so called polypharmacy. If the vaccine will take place of a part of medicine in future, it may give us a novel therapeutic option with several social benefits.


Assuntos
Hipertensão/terapia , Estilo de Vida , Vacinas/uso terapêutico , Humanos
3.
Rev Lat Am Enfermagem ; 27: e3166, 2019.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31596406

RESUMO

OBJECTIVE: to identify patterns of associations between the degree of compliance to laboratory test requests by risk strata and the parameters of quality of care outcomes in primary health care (PHC). METHOD: a cross-sectional study involving 108 elderly patients with hypertension and/or diabetes treated in PHC. A semi-structured questionnaire and electronic medical record data were used. To evaluate the quality of care, the Patient Assessment of Chronic Illness Care (PACIC) questionnaire was used. Descriptive analysis, multiple correspondence analysis and k-means grouping were performed. RESULTS: it was observed low compliance of the care practice, standing out as the worst parameter the evaluation of the diabetic foot (2.2%). Three clusters were identified, with cluster 1 having the highest number of individuals (37.0%), with better indicators of quality of care, evidenced by above 50% of compliance with laboratory tests (75.0%), high PACIC score (47.2%), control of blood pressure (70.0%) and metabolic levels (95.0%), and satisfaction with health (92.5%) and health access (90.0%). In contrast, cluster 3 (29.6%) was made up of individuals with worse outcomes of care. CONCLUSION: low compliance of care practice and asymmetries among health actions and users' needs were observed, indicating failures in the care process in PHC.


Assuntos
Diabetes Mellitus/terapia , Serviços de Saúde para Idosos/organização & administração , Hipertensão/terapia , Atenção Primária à Saúde , Qualidade da Assistência à Saúde/normas , Idoso , Idoso de 80 Anos ou mais , Brasil , Doença Crônica , Feminino , Serviços de Saúde para Idosos/normas , Humanos , Masculino , Cooperação do Paciente , Satisfação do Paciente , Encaminhamento e Consulta , Medição de Risco , Inquéritos e Questionários
4.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1139-1144, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31594161

RESUMO

Objective: To investigate the prevalence, awareness, treatment and control of hypertension in adult residents in Jiangsu province and provide evidence for the prevention and control of hypertension. Methods: A population-based cardiovascular disease screening project was conducted during 2015-2018 in Jiangsu, a total of 95 348 community-dwelling adults aged 35-75 years from 6 project areas were included in the study. The prevalence rate of hypertension and rates of awareness, treatment and control of hypertension in the adults with different characteristics were analyzed. Multilevel model was applied to identify the influencing factors. Results: Among 95 348 adults surveyed, 54 407 were hypertensive, the standardized prevalence rate was 48.1%. The prevalence rate was significantly higher in males than in females (62.1% vs. 54.0%, P<0.05). Among the hypertension patients, the rates of awareness, treatment and control of hypertension were 56.6%, 45.3% and 12.0% (standardized rates: 52.2%, 41.0% and 11.2%), respectively, and all the rates were positively associated with age (all P<0.05). Multilevel model analysis showed that those who were males, at older age, lived in rural area, suffered from diabetes, had frequent alcohol drinking and those who were overweight/obese had higher risk for hypertension (all P<0.05). Among people with hypertension, those who had younger age, lower education level, lower household income level and those who had frequent alcohol drinking had lower awareness, treatment and control rates of hypertension (all P<0.05). Conclusions: The prevalence rate of hypertension was high, but related awareness, treatment and control rates were low in adult residents in Jiangsu province. Comprehensive measures should be taken to improve awareness, treatment and control of hypertension in whole population, especially in young adults, and those with low education or income levels.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Hipertensão/epidemiologia , Adulto , Idoso , Conscientização , China/epidemiologia , Feminino , Humanos , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
6.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(4 (Supl)): 383-386, out.-dez. 2019. tab
Artigo em Português | LILACS | ID: biblio-1047316

RESUMO

Objetivo: Determinar a prevalência da disfunção erétil (DE) em pacientes com hipertensão arterial (HA) primária em tratamento medicamentoso e sua relação e análise do impacto psicossocial. Métodos: O estudo abordou homens hipertensos em tratamento medicamentoso e idade superior a 40 anos que foram avaliados segundo o Índice Internacional de Função Erétil (IIFE- 5), Escala de Ansiedade e Depressão e um questionário sobre sua opinião quanto à relação da DE com as medicações anti-hipertensivas. A dosagem da testosterona sérica foi usada para exclusão de causas orgânicas da DE. Os dados foram analisados visando identificar o coeficiente de correlação entre as varáveis. Resultados: Foi observada prevalência de DE em 74% dos pacientes e, destes, 43% referiram piora do desempenho sexual após uso crônico da medicação anti-hipertensiva. Não foi possível provar uma correlação direta entre o uso de anti-hipertensivos e a DE, entretanto observou-se aumento do coeficiente de correlação em função da progressão da idade dos pacientes. Os betabloqueadores mostraram maior coeficiente de correlação com a DE (25%), seguido dos inibidores da enzima conversora de angiotensina (19%). Dos pacientes, 43% foram classificados com provável diagnóstico de ansiedade ou depressão e 35% com possível diagnóstico. Conclusão: Foi possível inferir, mas não afirmar uma correlação entre DE, HA e o uso de anti-hipertensivos


Objective: To determine the prevalence of erectile dysfunction (ED) in patients with primary arterial hypertension (AH) undergoing drug treatment and its relationship and analysis of psychosocial impact. Methods: The study addressed hypertensive men on drug treatment and over 40 years of age who were evaluated according to the International Index of Erectile Function (IIFE-5), Anxiety and Depression Scale, and a questionnaire about their opinion regarding the relationship between ED and antihypertensive medications. Serum testosterone dosage was used to rule out the organic causes of ED. Data were analyzed to identify the correlation coefficient between variables. Results: Prevalence of ED was observed in 74% of patients and, of these, 43% reported worsened sexual performance after chronic use of antihypertensive medications. It was not possible to prove any direct correlation between the use of antihypertensive drugs and ED, however an increase in the correlation coefficient was observed as a function of patients' age progression. Beta-blockers showed higher correlation coefficient with ED (25%), followed by angiotensin-converting enzyme inhibitors (19%). 43% of patients were classified with probable diagnosis of anxiety or depression and 35% with possible diagnosis. Conclusion: It was possible to infer but not to affirm a correlation between DE, HA and the use of antihypertensive drugs


Assuntos
Hipertensão/terapia , Disfunção Erétil , Anti-Hipertensivos , Ansiedade , Doenças Cardiovasculares , Doença Crônica , Prevalência , Estudos Prospectivos , Inquéritos e Questionários , Fatores de Risco , Depressão , Tratamento Farmacológico
8.
Hypertension ; 74(4): 1041-1051, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31476904

RESUMO

Transient hypertension is a risk factor for Alzheimer disease (AD), but the effects of this interaction on brain vasculature are understudied. Addressing vascular pathology is a promising avenue to potentiate the efficacy of treatments for AD. We used arterial spin labeling magnetic resonance imaging to longitudinally assess brain vascular function and immunohistopathology to examine cerebrovascular remodeling and amyloid load. Hypertension was induced for 1 month by administration of l-NG-nitroarginine-methyl-ester in TgF344-AD rats at the prodromal stage. Following hypertension, nontransgenic rats showed transient cerebrovascular changes, whereas TgF344-AD animals exhibited sustained alterations in cerebrovascular function. Human umbilical cord perivascular cells in combination with scyllo-inositol, an inhibitor of Aß oligomerization, resulted in normalization of hippocampal vascular function and remodeling, in contrast to either treatment alone. Prodromal stage hypertension exacerbates latter AD pathology, and the combination of human umbilical cord perivascular cells with amyloid clearance promotes cerebrovascular functional recovery.


Assuntos
Doença de Alzheimer/fisiopatologia , Hipertensão/fisiopatologia , Doença de Alzheimer/etiologia , Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/metabolismo , Animais , Encéfalo/fisiopatologia , Modelos Animais de Doenças , Hemodinâmica/fisiologia , Hipertensão/complicações , Hipertensão/terapia , Imagem por Ressonância Magnética , Ratos , Marcadores de Spin
9.
Lancet ; 394(10205): 1231-1242, 2019 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488369

RESUMO

BACKGROUND: Hypertension is the leading cause of cardiovascular disease globally. Despite proven benefits, hypertension control is poor. We hypothesised that a comprehensive approach to lowering blood pressure and other risk factors, informed by detailed analysis of local barriers, would be superior to usual care in individuals with poorly controlled or newly diagnosed hypertension. We tested whether a model of care involving non-physician health workers (NPHWs), primary care physicians, family, and the provision of effective medications, could substantially reduce cardiovascular disease risk. METHODS: HOPE 4 was an open, community-based, cluster-randomised controlled trial involving 1371 individuals with new or poorly controlled hypertension from 30 communities (defined as townships) in Colombia and Malaysia. 16 communities were randomly assigned to control (usual care, n=727), and 14 (n=644) to the intervention. After community screening, the intervention included treatment of cardiovascular disease risk factors by NPHWs using tablet computer-based simplified management algorithms and counselling programmes; free antihypertensive and statin medications recommended by NPHWs but supervised by physicians; and support from a family member or friend (treatment supporter) to improve adherence to medications and healthy behaviours. The primary outcome was the change in Framingham Risk Score 10-year cardiovascular disease risk estimate at 12 months between intervention and control participants. The HOPE 4 trial is registered at ClinicalTrials.gov, NCT01826019. FINDINGS: All communities completed 12-month follow-up (data on 97% of living participants, n=1299). The reduction in Framingham Risk Score for 10-year cardiovascular disease risk was -6·40% (95% CI 8·00 to -4·80) in the control group and -11·17% (-12·88 to -9·47) in the intervention group, with a difference of change of -4·78% (95% CI -7·11 to -2·44, p<0·0001). There was an absolute 11·45 mm Hg (95% CI -14·94 to -7·97) greater reduction in systolic blood pressure, and a 0·41 mmol/L (95% CI -0·60 to -0·23) reduction in LDL with the intervention group (both p<0·0001). Change in blood pressure control status (<140 mm Hg) was 69% in the intervention group versus 30% in the control group (p<0·0001). There were no safety concerns with the intervention. INTERPRETATION: A comprehensive model of care led by NPHWs, involving primary care physicians and family that was informed by local context, substantially improved blood pressure control and cardiovascular disease risk. This strategy is effective, pragmatic, and has the potential to substantially reduce cardiovascular disease compared with current strategies that are typically physician based. FUNDING: Canadian Institutes of Health Research; Grand Challenges Canada; Ontario SPOR Support Unit and the Ontario Ministry of Health and Long-Term Care; Boehringer Ingelheim; Department of Management of Non-Communicable Diseases, WHO; and Population Health Research Institute. VIDEO ABSTRACT.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Participação da Comunidade/métodos , Hipertensão/complicações , Idoso , Colômbia , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/prevenção & controle , Hipertensão/terapia , Malásia , Masculino , Comportamento de Redução do Risco
10.
Medicine (Baltimore) ; 98(36): e16894, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31490374

RESUMO

Hypertension is a common global health problem including China. This study aimed to assess the prevalence and awareness of hypertension, and evaluate risk factors associated with hypertension among multi-ethnic population in northwest China using a random sampling cross-sectional data.A cross-sectional survey was conducted between 2014 and 2015 as part of a nationwide survey using stratified four-stage random sampling in Xinjiang. Hypertension was defined as mean systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥140/90 mm Hg and/or taking anti-hypertensive medication. In addition, the prevalence of hypertension (SBP ≥ 130 or DBP ≥ 80 mm Hg) was also estimated according to the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) High Blood Pressure Guideline. Awareness of hypertension was based on self-report. An optimized risk score model was used to assess the risk and determine the predictive power of risk factors on hypertension.Totally 6722 subjects aged ≥18 years were enrolled and prevalence of hypertension was 24.3%, while the prevalence of hypertension based on the 2017 ACC/AHA guideline was approximately twice as high as that based on 2010 Chinese guideline (37.6%). Among individuals with hypertension, 55.5% were aware of their condition. Six potential factors were estimated to be associated with increased risk of hypertension including age, ethnicity, marital status, body mass index (BMI), waistline circumference, and comorbidity. In the analyses of calculated risk score, BMI ≥ 28.0 corresponded to the highest risk score of 23 points. The area under the receiver operation curve for the multivariable prediction model was 0.803 (95%CI: 0.789-0.813).There is a considerable prevalence of hypertension among Xinjiang adults, northwest China; awareness of hypertension is low. Excess weight loss may be a vital strategy for controlling hypertension, particularly if accompanied with other preventive measures in this region.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hipertensão/etnologia , Hipertensão/terapia , Perda de Peso , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Glicemia , Índice de Massa Corporal , Pesos e Medidas Corporais , China/epidemiologia , Comorbidade , Estudos Transversais , Grupos Étnicos , Feminino , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Autorrelato , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
11.
Rev Med Suisse ; 15(662): 1597-1602, 2019 Sep 11.
Artigo em Francês | MEDLINE | ID: mdl-31508910

RESUMO

Hypertension is highly prevalent in elderly and represents the number one risk factor for cardiac and cerebrovascular complications including cognitive dysfunction. Recently published AHA/ACC and ESC/ESH guidelines for the management of hypertension in adults have modified the approach of hypertension in patients older than 65 years and particularly in those older than 85. The new concepts are the following: the thresholds and target blood pressures for patients older than 65 years are less conservative; emphasis is made on biological rather than chronological age; the use of single pill combinations is favored to simplify treatment algorithms and increase long-term drug adherence. At last, a regular assessment of adherence in collaboration with health care partners is highlighted.


Assuntos
Hipertensão/terapia , Guias de Prática Clínica como Assunto , Idoso , Humanos , Hipertensão/complicações
12.
Rev Med Suisse ; 15(662): 1620-1624, 2019 Sep 11.
Artigo em Francês | MEDLINE | ID: mdl-31508913

RESUMO

Obstructive sleep apnea syndrome (OSAS) and arterial hypertension (HT) are two frequent, often concomitant diseases, who are both associated with an increased cardiovascular risk. In the last years, an association between these two entities has been established. The purpose of this article is to review the current knowledge about the link between HT and OSAS, the pathophysiological mechanisms involved in the common genesis of the two conditions and the characteristics suggesting an underlying OSAS in a hypertensive subject. We will also update readers about the current screening of OSAS in which primary care physicians are directly involved, and review the pros and cons of different treatment options for HT in OSAS.


Assuntos
Hipertensão/complicações , Hipertensão/terapia , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/diagnóstico , Humanos , Hipertensão/fisiopatologia , Apneia Obstrutiva do Sono/fisiopatologia
13.
Rev Med Suisse ; 15(662): 1629-1632, 2019 Sep 11.
Artigo em Francês | MEDLINE | ID: mdl-31508915

RESUMO

Arterial hypertension (HT) affects hundreds millions of people suffering from chronic kidney disease: it could be a cause or a consequence. HT can aggravate their prognosis and then lead to a very high cardiovascular morbidity and mortality. HT must be systematically screened and optimally taken care of. However, general practitioners actually lack unambiguous guidelines regarding patients with kidney diseases. This article underlines the necessity and modalities of a precise diagnosis, and aims to discuss the last studies supporting new and better therapeutic targets. The pathophysiological aspects of HT in chronic kidney diseases are also discussed.


Assuntos
Hipertensão/complicações , Hipertensão/terapia , Insuficiência Renal Crônica/complicações , Humanos , Hipertensão/mortalidade , Guias de Prática Clínica como Assunto , Prognóstico , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/terapia , Fatores de Risco
17.
Zhongguo Zhen Jiu ; 39(8): 809-13, 2019 Aug 12.
Artigo em Chinês | MEDLINE | ID: mdl-31397123

RESUMO

OBJECTIVE: To observe the related factors of left ventricular configuration in patients with mild to moderate hypertension, and to evaluate the influence of acupuncture on left ventricular configuration and cardiac function. METHODS: Huoxue Sanfeng acupuncture regime formulated by academician SHI Xue-min was applied to 200 patients with mild to moderate hypertension. The treatment was given once a day, 5 times a week for 3 months. Blood pressure and blood lipid levels were measured before treatment. Before treatment and 3 months after treatment, the echocardiography was used to measured end-diastolic left ventricular diameter (LVIDd), end-diastolic left ventricular posterior wall thickness (LVPWTd), and end-diastolic interventricular septum thickness (IVSTd), ejection fraction (EF), left ventricular mass index (LVMI), etc.; the relevant influencing factors of different left ventricular configurations were analyzed. RESULTS: The patients with mild to moderate hypertension had left ventricular dysplasia (left ventricular remodeling, concentric hypertrophy, eccentric hypertrophy) reached 60%, and compared with the normal configuration group and the left ventricular remodeling group, there were significant differences in nighttime mean pulse pressure, total cholesterol, BMI and waist circumference in the eccentric hypertrophy group (P<0.05). LVMI was associated with nighttime pulse pressure, waist circumference, total cholesterol and BMI (P<0.05). Left ventricular relative wall thickness was associated with total cholesterol, BMI and waist circumference (P<0.05). The diastolic function from normal configuration to left ventricular remodeling, concentric hypertrophy and eccentric hypertrophy gradually decreased, but there were no significant difference (P>0.05). The systolic function in the concentric hypertrophy group and the eccentric hypertrophy group was significantly lower than that in the normal configuration group and the left ventricular remodeling group (P<0.05). There was no significant difference in left ventricular systolic function and diastolic function before and after acupuncture (P>0.05). CONCLUSION: Sixty percents of patients with mild to moderate hypertension have abnormal left ventricular configuration and are associated with total cholesterol, BMI, waist circumference and nighttime mean pulse pressure. Studies have not found that acupuncture can significantly improve the left ventricular configuration and left cardiac function.


Assuntos
Terapia por Acupuntura , Hipertensão/terapia , Pressão Sanguínea , Ventrículos do Coração , Humanos , Hipertrofia Ventricular Esquerda
18.
BMC Health Serv Res ; 19(1): 537, 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31366384

RESUMO

BACKGROUND: Hypertension and Diabetes mellitus are risk factors for cardiovascular diseases that cause 17 million deaths globally. Many of these deaths could have been prevented if hypertensive and diabetic patients had their blood pressure and glucose controlled. Less than 30% of hypertensive and diabetic patients on management have controlled their blood pressure and glucose respectively. This study aimed to determine the preparedness of health facilities in managing hypertensive and diabetic patients in terms of personnel; laboratory services provision, and local use of routinely collected data, and shows differences in preparedness between the levels of facilities. METHODS: We conducted a cross-sectional study in Government, faith-based and private health facilities in two districts in Kilimanjaro region in Tanzania from March to July 2017. We collected data through interviews and observations on the preparedness of the facilities for managing hypertension and DM. RESULTS: Forty-three (43) health facilities and 62 healthcare workers (HCW) participated in the survey. Services for hypertension and DM were available in 37 (86%) and 34 (79%) health facilities respectively. Eighteen (53%) and five (15%) facilities had HCW trained on hypertension and DM management respectively within two years preceding the survey. Regular adherence to treatment guideline was reported in 18 (53%) of the health facilities. More than third of health facilities were without basic equipment for managing hypertension and DM. All the recommended laboratory tests were only available in four (15%) hospitals and one health center. Valid first line medicines for both hypertension and DM were available in six (50%) health centers, four (24%) dispensaries and in four (80.0%) hospitals. Health data collection, analysis and local use for planning were reported in all hospitals, nine (75%) health centers and four (24%) dispensaries. CONCLUSIONS: Health facilities are not fully prepared to manage hypertension and DM. Health centers and dispensaries are mostly affected levels of health facilities. Government interventions to improve facility factors and collaborative approaches to build capacity to HCW are needed to enable health facilities be responsive to these diseases.


Assuntos
Diabetes Mellitus/terapia , Instalações de Saúde , Hipertensão/terapia , Estudos Transversais , Pesquisa sobre Serviços de Saúde , Humanos , Tanzânia
19.
20.
Int J Biometeorol ; 63(12): 1707-1718, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31402400

RESUMO

Hypertension is a major public health problem in the world, and the management of hypertension has always been a research of interest. Balneotherapy, with its recreational aspect, is more acceptable than medication intake and lifestyle change for the management of hypertension. The aim of this review was to summarize the current available data on the clinical effects of head-out immersion in natural thermal mineral water (HINTMW) as the most common method of balneotherapy used in the management of hypertension. We screened the PubMed, EMBASE, Cochrane Library, China Science and Technology Journal, China National Knowledge Infrastructure, WANFANG, and China Biology Medicine disc databases and selected 12 randomized controlled trials involving a total of 1122 participants. Among 12 trials, HINTMW was taken as the only intervention in only one study, HINTMW was taken in addition to basic antihypertensive drugs in three studies, and HINTMW was taken in combination with advice to follow nonpharmacological methods in one study involving participants who partly used antihypertensive drugs, while HINTMW combined with other interventions, such as natural convalescent factor therapy, psychotherapy, exercises, nutrition therapy, and integrated care, was taken in addition to basic antihypertensive drugs in the other 7 studies. Our results showed that natural thermal mineral water immersion alone or natural thermal mineral water immersion as an adjuvant therapy to medication or natural thermal mineral water immersion combined with other interventions had no adverse effects on hypertensive patients, and most even had positive effects. However, more high-quality evidences on therapeutic effectiveness of natural thermal mineral water immersion on hypertension are needed from additional randomized controlled trials with high methodological quality.


Assuntos
Balneologia , Hipertensão , Águas Minerais , China , Humanos , Hipertensão/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto
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