BACKGROUND

Medication compliance contributes to preventing significant morbidities, such as stroke, among hypertensive patients.

This study aimed to examine the factors affecting hypertensive patients' medication compliance in Sambag II, Cebu City.

This study is an observational cross-sectional study. The study was conducted in Barangay Sambag II of Cebu City and involved 170 random, voluntary, self-reporting hypertensive patients. The Tao Yamane formula was used to determine the sample size. An interviewer-guided survey questionnaire was utilized to collect the data for the pilot study. The data were analyzed using Cronbach’s Alpha Test for internal consistency and reliability.

Three factors were shown to influence compliance with antihypertensive medications. These are the source of medication, access to medication, and symptoms experienced before intake of anti-hypertensive medications. A factor that significantly affects compliance is the source of medication, wherein hypertensive patients prefer medications from retail pharmacies compared to the free medications supplied by the local health center.

Residents of Sambag II, Cebu City preferred medications from retail pharmacies over the free medications provided by the local health center. Local health units may use this information to implement information drugs regarding the efficacy of medications provided by government agencies. Further studies are recommended to use subgroup analysis on factors influencing compliance and non-compliance to anti-hypertensive medicines.

Schistosomiasis, a snail-borne disease caused by infection with a trematode parasite of the genus Schistosoma, is one of the most neglected tropical diseases in the world. One of its rare complications is hepatosplenic schistosomiasis which ultimately leads to fibrosis and presinusoidal portal hypertension.

We report a case of a 13-year-old Filipino male from Quezon City with previous one year residence in the endemic island of Leyte, presenting with melena. Diagnostic work-up revealed hepatosplenomegaly and periportal fibrosis with multiple hepatic nodules on ultrasound, positive Schistosoma japonicum eggs on Kato-Katz stool examination technique, and findings of esophageal varices on upper endoscopy. The patient was managed with praziquantel, propranolol, and endoscopic rubber band ligation of the esophageal varices, with note of resolution of bleeding, and improvement on sonographic liver findings.

The degree of liver fibrosis from schistosomiasis is affected by poorly understood mechanisms which affect its severity, progression, and complications, regardless of biosocial factors including egg burden and duration of parasite exposure. This is the first case report on a Filipino adolescent to document significant interval improvement, within four weeks of treatment, of the characteristic fibrotic pattern in hepatosplenic schistosomiasis. Hepatosplenic schistosomiasis is still often missed out as the diagnosis in patients who consult with common symptoms, and high index of suspicion is recommended for those with history of residence in endemic areas. Likewise, treatment focusing on parasite eradication can aid in promptly addressing the resulting fibrosis and its complications.

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.

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

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.

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.

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.

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.

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

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.

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.

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.

OBJECTIVE

This study aimed to estimate the incidence of hypertension and determine the risk factors for hypertension among apparently healthy adult Filipinos.

This observational prospective community-based study included apparently healthy adult individuals aged 20–50 years from the Life Course Study in Cardiovascular Disease Epidemiology (LIFECARE) Philippine cohort at baseline and followed-up after an average of four years. Sociodemographic data, psychosocial stress, and clinical and metabolic profiles were obtained and analyzed. Multivariable Cox regression analysis was performed to identify factors associated with the development of hypertension.

A total of 2,089 non-hypertensive participants were included, with 59% women and average age of 35 years (SD = 8.4). The incidence rate of hypertension was 38.1 per 1,000 person-years. The cumulative incidence of hypertension over a mean follow-up time of four years was 15.4% (95% CI = 13.9–17.0%). The risk of incident hypertension was higher among males (aHR=1.3, 95% CI: 1.0–1.8; p=0.044), ≥40 years old (aHR=3.9, 95% CI: 2.6–5.8; pCONCLUSION

The 4-year incidence rate of hypertension among apparently healthy adult Filipinos is high. Increased age, male sex, family history of hypertension, abdominal obesity, and high normal blood pressure were significantly associated with the development of hypertension.

INTRODUCTION

Eosinophilic Granulomatosis Polyangiitis (EGPA) is the rarest among the ANCA-associated vasculitis with an incidence of seven per million individuals. Cardiac involvement occurs in 15-60% of patients and is the most severe manifestation associated with poor prognosis and mortality. EGPA typically affects the left side of the heart. There is only one published study to date that describes a case of right sided heart failure from pulmonary arterial hypertension.

A 40-year-old, Filipino, female, complained of rash, wheezing and right sided heart failure symptoms. After a thorough work-up, she was managed as a case of EGPA based on palpable, erythematous, nonpruritic rash on the lower extremities, peripheral eosinophilia (54%), adult-onset asthma, mononeuritis multiplex, cardiac symptoms, (+) p-ANCA and leukocytoclastic vasculitis with eosinophils and early granuloma formation on skin punch biopsy. The 2D-echocardiography showed an elevated estimated pulmonary pressure with signs of right sided volume overload. Chest computed tomography with contrast revealed right atrial and biventricular enlargement, hepatomegaly and unremarkable pulmonary findings. Methylprednisolone along with intravenous cyclophosphamide pulse therapy were initiated which resulted in the resolution of symptoms with normalization of blood eosinophils. Repeat 2D-echocardiogram had unremarkable findings as well. With the improvement noted, she was then maintained on glucocorticoids and mycophenolate mofetil.

Although EGPA commonly presents with symptoms of asthma, rhinosinusitis and/or peripheral eosinophilia, one uncommon presentation would be cardiac manifestations, specifically progressive pulmonary arterial hypertension with subsequent right sided heart failure. High dose glucocorticoids along with other immunosuppressants such as cyclophosphamide, are the treatment options in managing life-threatening conditions. Early detection is crucial in the prevention of grave outcomes.

Objectives: This study aimed to describe the roles and responsibilities of doctors and nurses in managing conditions like hypertension and diabetes in rural areas. Methods: This study employed a cross-sectional study design using the task analysis methodology. A self-administered questionnaire derived from a national health practice guideline was used. A combination of frequency, criticality, and performance was assessed to identify tasks that needed attention by educators and policymakers. Results: Of the 142 health workers who participated in the study, 81% were nurses and 19% were doctors. The tasks most frequently performed by these professionals were taking vital signs (88.7%), recording patient history (87.3%), and advising patients on regular follow-ups (86.6%). In terms of criticality, the top three tasks were performing diagnostic tests for acute chest pain (50.8%), diagnosing neurological disorders (49.2%), and referring patients for specialized tests at other facilities (43.6%). However, the tasks perceived as most challenging or outside their capability were the Fagerstorm test for assessing nicotine dependence (57.5%), the AUDIT tool for identifying binge drinkers (55.5%), and fundoscopy for diagnosing diabetic retinopathy (54%). Conclusion The primary care practice of the participants typically involved tasks that are centered on health promotion or disease prevention. Many of the tasks are shared by doctors and nurses, with some highly critical tasks performed less frequently due to a lack of training. Pre-service courses may need to be revised to ensure that health professionals have the required skills to carry out shared tasks.
Diabetes Mellitus ; Hypertension ; Primary Health Care ; Delivery of Health Care, Integrated ; Philippines ; Cross-Sectional Studies

Humans ; Blood Pressure/physiology* ; Renal Insufficiency, Chronic ; Hypertension/drug therapy* ; Antihypertensive Agents/therapeutic use*

Humans ; Air Pollutants/adverse effects* ; Genotype ; China/epidemiology* ; Hypertension/epidemiology*

: Schistosomiasis, a snail-borne disease caused by infection with a trematode parasite of the genus Schistosoma, is one of the most neglected tropical diseases in the world. One of its rare complications is hepatosplenic schistosomiasis which ultimately leads to fibrosis and presinusoidal portal hypertension. : We report a case of a 13-year-old Filipino male from Quezon City with previous one year residence in the endemic island of Leyte, presenting with melena. Diagnostic work-up revealed hepatosplenomegaly and periportal fibrosis with multiple hepatic nodules on ultrasound, positive Schistosoma japonicum eggs on Kato-Katz stool examination technique, and findings of esophageal varices on upper endoscopy. The patient was managed with praziquantel, propranolol, and endoscopic rubber band ligation of the esophageal varices, with note of resolution of bleeding, and improvement on sonographic liver findings. The degree of liver fibrosis from schistosomiasis is affected by poorly understood mechanisms which affect its severity, progression, and complications, regardless of biosocial factors including egg burden and duration of parasite exposure. This is the first case report on a Filipino adolescent to document significant interval improvement, within four weeks of treatment, of the characteristic fibrotic pattern in hepatosplenic schistosomiasis. Hepatosplenic schistosomiasis is still often missed out as the diagnosis in patients who consult with common symptoms, and high index of suspicion is recommended for those with history of residence in endemic areas. Likewise, treatment focusing on parasite eradication can aid in promptly addressing the resulting fibrosis and its complications.
fibrosis ; hypertension, portal