OBJECTIVES

This study aimed at determining the association of the clinical profile of patients with GDM to maternal and neonatal outcomes

METHODS

This single-center, retrospective, descriptive, cross-sectional chart review was conducted in a tertiary hospital in Cebu City to 229 patients with GDM admitted from January 2021 to December 2022.

RESULTS

The study revealed several significant associations. Hypertension was strongly linked with primary cesarean section (OR: 4.32, P-value 0.004); and severe pre-eclampsia (OR: 16.97, P-value: 0.000). Gravidity showed significant correlations with Ballard’s score (P-value: 0.013), birthweight (P-value: 0.045) and 5-minute APGAR score (P-value: 0.001). Parity was associated with birthweight (P-value: 0.011) and 5-minute APGAR score (P-value: 0.001). Weight gain during pregnancy was linked to birthweight (P-value: 0.004) and occurrence of congenital anomalies (OR: 1.26, P-Value: 0.032). Additionally, prenatal smoking was associated with 5-minute APGAR score (P-value: 0.006). Moreover, having a Small for Gestational Age (SGA) fetal growth status is associated with insulin-requiring mothers, (OR: 4.79, P-Value: 0.049); and a family history of diabetes was significantly associated with insulin therapy (OR: 5.38, P-value: 0.021).

CONCLUSION

Patients' clinical profile affect maternal and neonatal outcomes among patients with GDM. Careful consideration of these factors during the perinatal period may help reduce maternal and fetal risks

Tertiary Care Centers ; Smoking ; Pregnancy ; Diabetes, Gestational ; Hypertension ; Apgar Score

OBJECTIVES

Clinical pathways (CPs) ensure adherence to heart failure (HF) management guidelines. To optimize quality care in a low resource setting, an evidence-based care pathway for the management of acute HF was implemented at the emergency department (ED) of the Philippine General Hospital (PGH), the designated national tertiary hospital and referral center. This study aimed to describe the characteristics of adults with acute HF admitted at the ED and evaluate the quality of care they received, measured using physician adherence to the hospital’s acute heart failure CP.

METHODS

This was a retrospective, descriptive cohort study. We reviewed the inpatient charts of all adult patients with acute HF admitted to the ED of the PGH and referred to the Division of Cardiovascular Medicine between December 1, 2022 and May 31, 2023. Quality of care was assessed based on adherence to quality indicators adapted from routine and conditional order sets detailed in the pathway. Descriptive statistics was utilized to describe patient characteristics, quality of care, and outcomes.

RESULTS

Two hundred thirty-six (236) patients were included, with a mean age of 51.8 years. Majority were male (53.4%); hypertension (61.4%) and ischemic heart disease (53.8%) were the most common comorbidities, and infection the most common precipitant of decompensation (60.6%). There were optimal adherence rates to routine orders, which included referrals to Internal Medicine and Cardiology, baseline vital signs monitoring, fluid intake and output monitoring, chest radiograph, complete blood count, blood urea nitrogen, sodium, potassium, prothrombin time, partial thromboplastin time, arterial blood gas, urinalysis, and N-terminal pro b-type natriuretic peptide. Conditional orders, such as oxygen support, focused echocardiography, thyroid - stimulating hormone, and the use of vasopressors, diuretics, and venous thromboembolism prophylactic agents, were optimally performed when warranted. However, we noted suboptimal adherence to certain resource-intensive conditional orders, such as hourly monitoring of urine output (61.4%), hooking to cardiac monitor (53.8%), and performance of 12-lead ECG within 10 minutes (56.8%). Further, only 43.9% of patients were referred to the intensive care unit. Troponin I, calcium, magnesium, and albumin were ordered in excess.

CONCLUSION

Overall adherence rate of physicians to the hospital’s Acute Heart Failure Pathway was satisfactory. Work is needed to improve adherence to hourly urine output monitoring, consistent hooking to cardiac monitor, and timely performance of 12-lead ECG – an effort that begins with expanding in-hospital diagnostic equipment and human resource supply. We recommend continuous pathway implementation with periodic evaluation and stakeholder feedback to further improve quality of care.

Human ; Male ; Female ; Middle Aged: 45-64 Yrs Old ; Adult ; Albumins ; Blood ; Blood Urea Nitrogen ; Calcium ; Cardiology ; Chart ; Charts ; Cohort Studies ; Critical Care ; Critical Pathways ; Diagnostic Equipment ; Disease ; Diuretics ; Echocardiography ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Equipment And Supplies ; Evaluation Studies As Topic ; Feedback ; Heart ; Heart Diseases ; Heart Failure ; Hormones ; Hospitals ; Hospitals, General ; Humans ; Hypertension ; Indicators And Reagents ; Infection ; Infections ; Inpatients ; Intensive Care Units ; Internal Medicine ; Lead ; Magnesium ; Male ; Medicine ; Myocardial Ischemia ; Natriuretic Peptide, Brain ; Natriuretic Peptides ; Nitrogen ; Overall ; Oxygen ; Partial Thromboplastin Time ; Patients ; Peptides ; Philippines ; Physicians ; Potassium ; Prothrombin ; Prothrombin Time ; Quality Of Health Care ; Referral And Consultation ; Sodium ; Statistics ; Tertiary Care Centers ; Thorax ; Thromboembolism ; Thromboplastin ; Thyroid Gland ; Time ; Troponin ; Troponin I ; Universities ; Urea ; Urinalysis ; Urine ; Venous Thromboembolism ; Vital Signs ; Work ; Workforce

BACKGROUND AND OBJECTIVES

Technological advancements are reshaping healthcare, particularly through mobile health (mHealth) applications that aid chronic disease management. Medication tracking apps, such as Simpill, have shown potential in improving outcomes for conditions like hypertension. However, disparities in digital literacy and concerns related to technology acceptance and privacy may hinder effective use. Grounded in the principles of the Design Thinking approach, this study sought to evaluate the relationship between health-seeking behavior (HSB), perceived barriers (PB), and the perceived usability (PU) of Simpill among middle-aged hypertensive adults. The research aimed to capture not only measurable associations but also to inform future app development through a user-centered lens that prioritizes empathy and real-world usability.

METHODS

A quantitative, descriptive-correlational research design was employed to assess respondents’ HSB, PB, and PU related to Simpill. The study was guided by core phases of the Design Thinking framework, particularly empathize and define, to ensure a deep understanding of user needs and usability constraints. Data were collected using a four-part, researcher-modified questionnaire administered to 138 purposively selected middle-aged adults (30–59 years old) residing in Barangay Industrial Valley, Zone 6, Marikina City, Philippines. All participants had a confirmed diagnosis of hypertension. Correlational analyses, including Kendall’s Tau B, were conducted to examine relationships among the variables. The integration of Design Thinking informed the development and interpretation of questionnaire items, aligning them with real-world challenges experienced by the target users.

RESULTS

The study investigated the relationship between HSB, PB, and the PU of Simpill among 138 middle-aged hypertensive individuals. Most respondents were female (55.8%), aged 50–59 (47.8%), and employed in non health-related sectors (95.7%). HSB levels were gene rally high (mean = 3.23), particularly in actively seeking health information, while lower engagement was noted in routine vital sign monitoring. PB were moderate (mean = 2.06), with unfamiliarity with the application cited as a common issue. PU was also rated as moderate (mean = 2.80), although ease of use received a low score (mean = 1.99). A weak positive correlation was found between HSB and PU (Kendall’s Tau B = 0.123, p = 0.049), while a moderate negative correlation existed between PB and PU (Tau B = -0.402, p < 0.001). These findings reflect insights derived from the Design Thinking "empathize" phase, suggesting that while proactive health behaviors may modestly support app engagement, unresolved user pain points—such as poor usability and lack of familiarity—remain significant obstacles to adoption. The results underscore the importance of moving to the "ideate" and "prototype" phases, where such user insights can directly shape the redesign and improvement of mHealth tools.

CONCLUSION

The study identified a high level of health- seeking behavior, reflecting the respondents’ engagement with their health and openness to guidance, consistent with the user-empathy foundation of Design Thinking. Moderate perceived barriers highlight existing challenges in technology adaptation, particularly among those who prefer traditional methods. The moderate PU rating of Simpill, especially in terms of ease of use, suggests the app’s current design does not fully align with user capabilities or expectations. In line with Design Thinking principles, particularly user-centered innovation, the findings emphasize the need to involve users in iterative co-design processes to improve mHealth solutions. Addressing perceived barriers through enhanced digital literacy, usability testing, and interface refinement could substantially boost app acceptance and effectiveness in real-world settings.

Human ; Hypertension ; Mobile Applications ; Health Behavior ; User-centered Design

INTRODUCTION

Secondary hypertension should be suspected among young individuals and patients with recent onset of hypertension or drug-resistant hypertension. Among the causes of secondary hypertension, renovascular hypertension is well-established and correctible if diagnosed appropriately. We report the case of a young female with an unusual cause of renovascular hypertension.

CLINICAL PRESENTATION:

A 29-year-old female was admitted for elevated blood pressure and headache, unresponsive to multiple antihypertensives. The workup for secondary hypertension was mostly unremarkable. However, renal Doppler ultrasound showed elevated peak systolic velocity in the left renal artery. CT angiogram revealed an outpouching between the left gonadal and renal veins. No renal artery stenosis was found on renal angiography, but venography revealed an aneurysm between the left gonadal and renal veins. An aberrant vein draining into the inferior vena cava (IVC) and severe reflux into a dilated left gonadal vein were also noted.

MANAGEMENTCONCLUSION

This case highlights a rare cause of renovascular hypertension due to renal vein congestion from severe left gonadal vein reflux and a renal/gonadal vein aneurysm. Additional mechanisms may include external compression of the renal artery or a suction effect caused by multiple venous outflows. Regardless of the exact pathophysiology, coiling of the aneurysm and gonadal vein successfully restored normal venous return and resolved hypertension.

Human ; Female ; Adult: 25-44 Yrs Old ; Veins ; Research Report ; Renal Veins ; Pharmaceutical Preparations ; Patients ; Hypertension, Renovascular ; Hypertension ; Female ; Aneurysm

BACKGROUND

Blood pressure (BP) is a vital sign that is essential in the management of hypertension, thus, there is a need for accurate measurement of BP. This will allow for proper diagnosis and management of hypertension preventing cardiovascular morbidity and mortality among Filipino patients.

METHODOLOGY

This validation study utilized the US Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) protocol for BP monitors. A total of eighty-five (85) participants had their BP measured using both the HEM 7156 and a validated aneroid sphygmomanometer. The same-sequential BP measurement was recommended to be used and a total of nine readings were collected per individual. The mean average of BP and standard deviation were extracted from the measurements. The AAMI/ESH/ISO recommends the use of certain criteria for individual BP readings (criterion 1) and individual participants (criterion 2). Appropriate statistical analysis was used for other demographic data.

RESULTS

The participants had an average age of 34 years, more than half were females, and not diagnosed with hypertension. Individuals who were diagnosed with hypertension had no other comorbidities and were on single pill only. The average arm circumference was 26.9 cm. Blood Pressure (BP) readings were adequate based on the protocol. Validity results showed that for criterion 1, systolic blood pressure (SBP) difference was 3.4 ± 7.4 mmHg, while diastolic blood pressure (DBP) was 2.0 ± 8.0 mmHg. The results for criterion 2 showed for SBP was 3.3 ± 5.3 mmHg, while DBP was 1.9 ± 6.6 mmHg. The results satisfied a passing grade on the validation protocol set by the AAMI/ESH/ISO.

CONCLUSION

This study showed that OMRON HEM 7156 is validated as a BP apparatus and may be recommended for Philippine use.

Human ; Hypertension

Globally, an estimated 1.28 billion adults aged 30–79 years have hypertension (HTN), most of them (two-thirds) living in low- and middle-income countries (WHO 2023 report). The demographic of blood pressure (BP) in both genders differs with aging. In peopleyounger than 65 years of age, BP levels in men are higher compared to those of women. Conversely, at age 65 years and older, more women have been found to have elevated BP. Likewise, the cumulative incidence of increased adverse cardiovascular (CV) events in women has been reported as they age. Aside from aging, the influence of bio-social factors among women has been implicated in the development of HTN, such as health status—use of oral contraceptive pills (OCP), menopausal stage, obesity and having polycystic ovarian syndrome (PCOS) disease and socioeconomic condition—educational background, employment status and nuclear family setting. This paper will discuss how these factors affect the development of HTN and the approach of management among affected women from the reproductive to postmenopausal stage of life.

Human ; Female ; Hypertension

The growing population of senior citizens in the Philippines faces increased vulnerability to co-existence of two or more chronic diseases, highlighting the complex interplay of health, socioeconomic, and healthcare access challenges in this age group. This case report presents a 71-year-old Filipino female from Barangay Bunuanan, Catbalogan City, Samar, diagnosed with hypertension, gout, and diabetes mellitus. The patient experiences difficulties common to elderly individuals in the Philippines, including financial limitations and managing multiple chronic illnesses. Laboratory tests revealed elevated blood uric acid, borderline high lipid profile, and an HbA1c level indicative of poor glycemic control. The case highlights the complexity of multimorbidity in the elderly and the impact of socioeconomic factors on disease management.

Human ; Female ; Aged: 65-79 Yrs Old ; Elderly ; Aged ; Hypertension ; Gout ; Multimorbidity

BACKGROUND

According to the 2020 Philippine Health Statistics, hypertension ranks as the second leading cause of morbidity in the country. It is also the most common reason for medical consultations at the Quezon City General Hospital Family Medicine Outpatient Clinic. Various treatments, including plant-based options, have shown potential additional benefits in managing the condition.

OBJECTIVES

The primary objective of this study was to determine the effectiveness of Lemongrass (Cymbopogon citratus) capsule as an adjunct therapy to Losartan 50mg tablet in the treatment of newly diagnosed hypertensive patients of Quezon City General Hospital. 

METHODS

Newly diagnosed hypertensive patients consulting at the Family Medicine of Quezon City General Hospital qualifying the inclusion criteria enrolled in this Randomized Control Trial.

Patients who met the inclusion criteria initially received Losartan 50 mg once daily for two weeks. After this period, they were divided into two groups and received different treatment regimens for four weeks. Parameters such as systolic, diastolic, and mean arterial pressure were recorded daily and subsequently summarized. A crossover of treatment among subjects was then implemented, and the same parameters were measured again. However, no washout period was conducted prior to the crossover due to logistical constraints and ethical considerations, as discontinuation of standard antihypertensive therapy was not permitted. Statistical analysis using the Paired t-test and Two-sample t-test was performed based on the data collected from the study results.

RESULTS

There was a statistically significant difference in the systolic, diastolic and mean arterial pressure for the two groups. Group A who took Losartan 50mg tablet and Lemongrass capsule for one month, had a mean difference of 6.28 (p-value= < 0.001), 1.59 (p-value= < 0.0042) and 3.15 (p- value= < 0.001) respectively, had lower parameters after Phase I of treatment, compared to Group B who took Losartan 50mg tablet alone. After Phase II (cross-over of treatment), there is a statistically significant difference for the two groups. Group B who took Losartan 50mg tablet and Lemongrass capsule for one month, had a lower diastolic and mean arterial pressure, with a mean difference of 1.33 (p-value=0.01), and 1.47 (p-value=0.0047) respectively. Meanwhile, there was no observed significant difference in the systolic blood pressure with a mean difference of 1.71 (p-value=0.0675). 

CONCLUSION

Lemongrass capsule as adjunct in the treatment of newly diagnosed hypertensive patients was proven to be effective, safe and cost effective.

Human ; Hypertension ; Losartan ; Lemongrass ; Cymbopogon

BACKGROUND

Hypertension is a significant global health issue linked to high mortality and morbidity rates. It contributes not only to organ damage but also to psychological disorders such as anxiety and depression. Despite the rise in hypertensive patients experiencing these mental health issues, evidence remains insufficient.

OBJECTIVE

This systematic review and meta-analysis aimed to assess the prevalence of anxiety and depression among hypertensive patients.

METHODS

Observational studies published between 2020 and 2024 were sourced from PubMed, The Cochrane Library, and Google Scholar. The Newcastle-Ottawa Scale, adapted for cross-sectional studies, was utilized to evaluate study quality. A random-effects model was employed for meta-analysis to estimate the prevalence rates of anxiety and depression, alongside subgroup and sensitivity analyses to identify sources of heterogeneity.

RESULTS

Fifteen studies were included, with 14 eligible for quantitative analysis. The findings indicated a prevalence rate of 35% for depression (95% CI: 26%-44%) and 41% for anxiety (95% CI: 4%-78%) among hypertensive patients. Significant heterogeneity was observed in the studies (I²=98.3% for depression, I²=99.9% for anxiety). Subgroup analyses highlighted variability in assessment scales (p < 0.001), but not by region or population source. No publication bias was identified (p = 0.663 for depression, p = 0.710 for anxiety). Factors associated with depression included uncontrolled hypertension, female gender, marital status, and social support, while anxiety was linked to similar factors plus concerns about hypertension complications.

CONCLUSION

Depression and anxiety prevalence among hypertensive patients ranges from 30-42%. Uncontrolled hypertension and social support significantly impact mental health, with major barriers to psychiatric care compliance including economic constraints, lack of education, and comorbidities.

Human ; Hypertension ; Depression ; Anxiety ; Prevalence

BACKGROUND

Hypertensive patients have a high risk of developing mental health conditions such as anxiety and depression. Conflicting studies are available regarding the association of blood pressure control among hypertensive patients diagnosed with comorbid anxiety and/or depression.

OBJECTIVE

This study aimed to determine the association of hypertension control with anxiety and depression symptoms among patients in a tertiary hospital in La Union.

METHODS

A cross-sectional analytical study was conducted among 382 hypertensive patients at the outpatient department of Ilocos Training and Regional Medical Center. A validated Filipino translation of the Hospital Anxiety and Depression Scale questionnaire was used to measure depression and anxiety symptoms. Descriptive statistics, such as frequency, percentages, mean, and standard deviation were used. The chi-square test and t-test were applied to compare anxiety and depression with socio-demographic profiles and blood pressure control through odds ratios.

RESULTS

Out of the 382 participants, 23% have anxiety symptoms, 7.3% have depression symptoms, and 4.2% have both conditions. Age and low income were significantly associated with depression symptoms while living alone was statistically associated with anxiety symptoms. Low educational attainment was significantly associated with both depression and anxiety symptoms. While no association was found between depression symptoms and blood pressure control, the presence of anxiety symptoms increases the likelihood of poor blood pressure control.

SUMMARY/CONCLUSIONS

Hypertensive patients may experience depression and anxiety symptoms. In addition, the presence of anxiety symptoms contributes to poor BP control. Hence, early detection and regular screening of mental health conditions should be implemented to improve health outcomes and reduce the burden of disease in this population.

Human ; Anxiety ; Depression ; Hypertension