The standardized hypertension management provided by primary health care workers is an important part of China's recent health care reform efforts. Investigating 5,116 hypertensive patients from a cross-sectional survey conducted by the Chinese Center for Disease Control and Prevention in 2012, this study found that adherence to standardized hypertension management is associated with positive effects on hypertension- related knowledge, healthy lifestyle behavior, antihypertensive medical treatments, and blood pressure control. It will be necessary to provide primary health care workers with sufficient training and reasonable incentives to ensure the implementation and effectiveness of hypertension management.
Adult ; Aged ; Aged, 80 and over ; China ; Cross-Sectional Studies ; Female ; Guideline Adherence ; statistics & numerical data ; Health Care Reform ; legislation & jurisprudence ; Health Care Surveys ; Health Knowledge, Attitudes, Practice ; Healthy Lifestyle ; Humans ; Hypertension ; psychology ; therapy ; Male ; Middle Aged ; Patient Compliance ; psychology ; statistics & numerical data

Non-drug treatment of hypertension has become a research hotspot, which might overcome the heavy economic burden and side effects of drug treatment for the patients. Because of the good treatment effect and convenient operation, a new treatment based on slow breathing training is increasingly becoming a kind of physical therapy for hypertension. This paper explains the principle of hypertension treatment based on slow breathing training method, and introduces the overall structure of the portable blood pressure controlling instrument, including breathing detection circuit, the core control module, audio module, memory module and man-machine interaction module. We give a brief introduction to the instrument and the software in this paper. The prototype testing results showed that the treatment had a significant effect on controlling the blood pressure.
Biofeedback, Psychology ; methods ; Blood Pressure ; Humans ; Hypertension ; therapy ; Physical Therapy Modalities ; instrumentation

OBJECTIVEWith functional magnetic resonance imaging (fMRI), cerebral function imaging of acupuncture and sham acupuncture at Taichong (LR 3) in patients with essential hypertension (EH) was observed to analyze central mechanism of Taichong (LR 3) to treat EH.

METHODSEighteen EH patients were divided into a twisting acupuncture group (10 cases) and a sham acupuncture group (8 cases), which were treated with twisting manipulation and sham acu- puncture at right Taichong (LR 3), respectively. The treatments were both given with 30-second manipulation and 30- second interval for totally 5 min. During the acupuncture, fMRI was adopted to scan the cerebral function imaging of EH patients on resting state, and the acquired data were analyzed with SPM2 module in Matlab software.

RESULTSAcupunc- ture at Taichong (LR 3) in EH patients mainly increased opposite-side oxygen consumption, which generally activated left anterior cingulated gyrus (BA 32), left inferior parietal lobule (BA 40), left inferior temporal gyrus (BA 19), left middle temporal gyrus (BA 37) and right anterior central gyrus (BA 6). The activated areas were related to motor, vision and cognition of emotion. Stimulation region of sham acupuncture mainly included right anterior cingulated gyrus (BA 24), left inferior parietal lobule (BA 40) and left inferior frontal gyrus (BA 7).

CONCLUSIONThe central mechanism of Tai- chong (LR 3) on antihypertensive effect and symptom improvement is not in thalamus and medulla that are traditionally believed to control blood pressure. Taichong (LR 3) could activate anterior cingulated gyrus to regulate parasympathetic nerve and lower blood pressure, and through anterior cingulated gyrus, the connection with the surrounding areas is strengthened to improve the cognitive impairment caused by long-term hypertension.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Brain ; diagnostic imaging ; Cognition ; Essential Hypertension ; Female ; Humans ; Hypertension ; diagnostic imaging ; psychology ; therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography

PURPOSE: The purpose of this study was to examine the effect of a medication self-management education program on medication awareness, communication with health care provider, medication misuse behavior, and blood pressure in elders with hypertension. METHODS: The research design for this study was a non-equivalent control group quasi-experimental design. Participants were 23 elders for the control group, and 26 elders for the experimental group. The experimental group participated in the medication self-management education program which included the following, verbal education, 1:1 consultation, practice in medication self-management, and discussion over 5 sessions. Data were analyzed using the SPSS 18.0 program. RESULTS: There were statistically significant differences between the experimental and control group for medication awareness, medication misuse behavior, and communication with health care providers. However, no significant difference was found between the two groups for blood pressure. CONCLUSION: The results indicate that the education program is effective in improving medication awareness and communication with health care providers and in decreasing medication misuse behavior. Therefore, it is recommended that this education program be used as an effective intervention for improving medication self-management for elders with hypertension.
Aged ; Aged, 80 and over ; Antihypertensive Agents/therapeutic use ; Awareness ; Blood Pressure ; Female ; Humans ; Hypertension/drug therapy/*psychology ; Male ; Patient Education as Topic ; Prescription Drug Misuse ; *Program Evaluation ; Questionnaires ; *Self Care

INTRODUCTIONLittle is known about the sociodemographic and clinical profile of older adults with intellectual disabilities (ID) in Singapore. We studied the sociodemographic and clinical profile of older adults with ID and investigated factors associated with caregiver availability and identity in this population.

MATERIALS AND METHODSThe study population involved all adults with ID aged ≥40 years receiving services from the Movement for the Intellectually Disabled of Singapore (MINDS), the largest such provider in Singapore. Information on sociodemographic and clinical profiles, functional status, and availability of caregivers were collected via interviewer-administered questionnaires from guardians of older adults with ID. Descriptive characteristics were computed and chi-square and logistic regression identifi ed predictors of caregiver availability and identity.

RESULTSParticipation was 95% (227/239). There were differences in client age, gender, and caregiver availability between recipients of residential and non-residential services (all P <0.05). Common comorbidities included hyperlipidaemia (17.6%), hypertension (15.9%), psychiatric diagnoses (16.3%) and epilepsy (10.6%). The majority were fully independent in basic activities of daily living, but only 21.1% were fully communicative. Only a small minority (9.4%) were exercising regularly. The majority (73.5%) of clients had a primary caregiver; almost equal proportions relied on either parents or siblings. Older client age was associated independently with the lack of a primary caregiver, independent of greater functional dependence and presence of medical comorbidities in the client.

CONCLUSIONOlder adults with ID have multiple medical, functional, and social issues. More can be done to support the care of this unique group of adults with special needs.

Activities of Daily Living ; Adult ; Age Factors ; Caregivers ; classification ; statistics & numerical data ; supply & distribution ; Chi-Square Distribution ; Comorbidity ; Demography ; Epilepsy ; epidemiology ; Female ; Humans ; Hyperlipidemias ; epidemiology ; Hypertension ; epidemiology ; Intellectual Disability ; epidemiology ; physiopathology ; psychology ; therapy ; Logistic Models ; Male ; Mental Disorders ; epidemiology ; Quality of Life ; Singapore ; epidemiology ; Social Support ; Socioeconomic Factors

OBJECTIVE: To investigate the effect of antidepressant and psychological intervention on the blood pressure and quality of life in hypertensive patients with depression. METHODS: After evaluating 950 patients with essential hypertension by Hospital Anxiety and Depression Scale (HAD), patients with HAD positive results were evaluated with Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA). The positive subjects with HAMD were randomly divided into an antidepressant and psychological intervention group (n=30, including routine treatment, mental state intervention, and antidepressant treatment) and a control group (n=30, routine treatment alone). The blood pressure, quality of life, and level of depression were compared between the 2 groups. RESULTS: The depression symptoms were significantly improved in the antidepressant and psychological intervention group. The HAMD score fell from 30.03+/-1.83 at entrance to 17.43+/-1.96 at the end of study. The blood pressure control was more effective in the antidepressant and psychological intervention group than in the control group. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) decreased by 26.17 mmHg and 13.63 mmHg in the antidepressant and psychological intervention group, while there were only 14.32 mmHg and 7.18 mmHg decrease in SBP and DBP respectively in the control group. Patients in the antidepressant and psychological intervention group had a higher score in the quality of life. The total score of GQOLI-74 increased from 65.97+/-4.68 before the treatment to 71.20+/-5.13 after the treatment. CONCLUSION Psychological intervention and antidepressant can improve the blood pressure control and quality of life in hypertensive patients with depression.
Adult ; Antidepressive Agents ; therapeutic use ; Blood Pressure ; drug effects ; Depression ; complications ; therapy ; Female ; Humans ; Hypertension ; complications ; drug therapy ; psychology ; Male ; Middle Aged ; Psychotherapy ; Quality of Life

PURPOSE: This study aimed to compare self-care behaviors and depressive symptoms between the young old (65-74 yr) and the old-old (75-84 yr) in low-income women with hypertension. METHODS: This study used a descriptive research design. The subjects of this study were 136 elderly women over 65 yr living in D city. Data was collected from September to December 2007 through personal interviews using a questionnaire. The collected data was analyzed using the SPSS WIN 12.0 Program. RESULTS: Self-care behaviors, functional status, and number of medications showed a significant difference between young elderly and middle elderly. There was a negative correlation between self-care behaviors and depressive symptoms. 52.2% of variance in self-care behaviors of young elderly and 76.8% of variance in self-care behaviors of middle elderly were explained by depressive symptoms, number of medications, and functional status. CONCLUSION: It is necessary to manage depressive symptoms to improve the self-care behaviors of low-income elderly with hypertension. Depressive symptoms need to be considered in planning hypertension programs for low-income elderly women.
Aged ; Aged, 80 and over ; Data Interpretation, Statistical ; *Depression ; Female ; Health Behavior ; Humans ; Hypertension/etiology/*psychology/therapy ; Interviews as Topic ; Questionnaires ; *Self Care ; Social Support ; Socioeconomic Factors

PURPOSE: The purpose of this study was to analyze effects of a community-based case management program for clients with hypertension living in the community. METHODS: The research design was a one group pre and post-test design with 30 participants with hypertension who agreed to participate in the 8-12 week case management program provided by case managers from the National Health Insurance Corporation in 2002. Data were collected three times, before and after the case management services, and 6 months later. Outcomes included changes in blood pressure, knowledge of hypertension and daily life practices, including alcohol consumption, smoking, exercise, and medication adherence. RESULTS: Repeated-measures ANOVA and post-hoc tests of means revealed significant differences before and after service for systolic blood pressure, daily life practices (monitoring body weight and BP, low salt and cholesterol and high vegetable diet, and stress-relief practices), and exercise. The goal for medication adherence was attained after service. Significant improvements from baseline to 6 months after service were observed in measures of salt and vegetables in diet. There were no significant differences on hypertension knowledge, alcohol consumption or smoking behavior between before service and after, and at 6 months. CONCLUSION: The findings provide preliminary evidence that case management intervention can have positive outcomes on BP control, daily life practices, exercise, and medication adherence for clients with hypertension. However, additional interventions are needed to sustain long-term effects.
Activities of Daily Living ; Aged ; Alcohol Drinking/prevention & control/psychology ; Blood Pressure ; Case Management/*organization & administration ; Community Health Services ; Diet, Sodium-Restricted ; Female ; Humans ; Hypertension/psychology/*therapy ; Korea ; Male ; Medication Adherence/psychology ; Middle Aged ; Patient Education as Topic ; Smoking Cessation/psychology

PURPOSE: This study was to develop and prove the effects of aself management compliance promotion program for primary hypertension patients who reside in rural communities. METHOD: The content of the self management compliance promotion program developed by this study was as follows: A leader trains patients as a group or individually, in walking, education and green tea therapy from the first to twelfth week. From the thirteenth to twenty fourth week, the patients should perform walking and green tea therapy by themselves. One hundred twenty subjects volunteered to participate in the study, who were among those registered as hypertension patients in the 14 community health clinics located in Chungcheongbuk-do. RESULT: Systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglyceride, step width, and degree of obesity decreased significantly. High-density lipoprotein cholesterol, step length, knowledge of hypertension, and self management compliance significantly increased. CONCLUSION: A self management compliance promotion program for primary hypertensive patients enhances biophysical index and knowledge on hypertension, thus ultimately suggesting a nursing intervention for promoting self management compliance.
Adult ; Aged ; Aged, 80 and over ; Female ; Health Promotion ; Humans ; Hypertension/psychology/*therapy ; Life Style ; Male ; Middle Aged ; Patient Compliance ; *Patient Education as Topic ; Rural Population ; *Self Care

PURPOSE: This study was done to identify and test a model of the psychosocial variables that influence adherence to therapeutic regimens in patients with hypertension. METHOD: A convenience sample of 219 patients with hypertension who were enrolled in an outpatient clinic of a cardiovascular center in Korea participated in the study. They completed self-administered questionnaires anonymously. The questionnaire was based on the Social Action Theory model and a literature review. The explanatory model was constructed and tested using structural equation modeling in order to examine the effects within the model. RESULTS: The results of this study showed that perceived self-efficacy was the strongest factor influencing patient adherence in this sample. Adherence to therapeutic regimens in patients with hypertension was influenced by self-efficacy, patient-provider relationship, social support, and depression. CONCLUSIONS: Adherence to therapeutic regimens in patients with hypertension was most strongly influenced by self-efficacy. These findings suggest that nursing interventions to promote patient adherence should focus on the promotion of self-efficacy including improvement in patient-provider relationship and social support, and reduction in depression.
Social Support ; Self Efficacy ; Patient Compliance/*psychology ; Models, Psychological ; Middle Aged ; Male ; Korea ; Hypertension/*drug therapy ; Humans ; Health Knowledge, Attitudes, Practice ; Female ; Factor Analysis, Statistical ; Depression/psychology ; Aged