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Approach by Health Professionals to the Side Effects of Antihypertensive Therapy： Strategies for Improvement of Adherence

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Journal of Pharmacy and Pharmacology 2018年第4期6卷 340-349页

作者： grazia maria guerra Heno Ferreira Lopes ELizangela Oliveira Freitast Fernanda Marciano Consolim-Colombo Patricia Silva Lessa4, Dante Marcelo Artigas Giorgi Luiz Aparecido Bortolloto Eduardo Moacyr Krieger Hypertension Unit Heart Institute of Hospital Clinical (InCor-HC FMUSP) School of Medicine University of Sao Paulo Sao Paulo 05403-000 SP Brazil Sao Camilo University Centers Sao Paulo 05022-000 SP Brazil Institute of Cancer of Sao Paulo State Sao Paulo 01246-000 SP Brazil Department of Electronics and Systems (DES-UFPE) Federal University of Pernambuco Recife 50670-901 PE Brazil

The aim was to determine whether complaints about side effects made by stage Ill hypertensive patients undergoing antihypertensive therapy lead to adequate blood pressure control. Forty-eight patients were monitored by a nurse every 15 days over the course of 180 days. At baseline, both groups presented similar SBP （systolic blood pressure）（GA, 196 （5）） mm Hg and GB, 189 （6） mm Hg） and DBP （diastolic blood pressure）（GA, 122 （3） mm Hg and GB, 121 （4） mm Hg）. On day 165, after a progressive decline in blood pressure levels, the two groups differed significantly from each other regarding SBP （GA, -16.9 （24） mm Hg and GB, -40.8 （31） mm Hg）. At the final follow-up, the patients were allocated to two groups： without complaints （GA） and with （GB） complaints about side effects. Complaining about side effects was a decisive factor for immediate nursing intervention and improved control over BP.

关键词： Nursing hypertension patient adherence side effect ambulatory blood pressure monitoring.

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The Health Education Program Implemented by Nurses Can Improve Blood Pressure Control and Quality of Life in Hypertensive Patients？

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Journal of Health Science 2018年第5期6卷 365-373页

作者： guerra, grazia maria Lopes, Heno Ferreira Freitas, Elizangela de Oliveira Tsunemi, Miriam H. Giorgi, Dante Marcelo Artigas Vieira, Margarida Consolim-Colombo, Fernanda M. Bortolotto, Luiz Aparecido Hypertension Unit Heart Institute (InCor HC FMUSP) Medical School of Medicine University of Sao Paulo Sao Paulo SP 05403-000 Brazil Sao Camilo University Centers Sao Paulo SP 05022-000 Brazil Cancer Institute of the State of Sao Paulo (ICESP) Sao Paulo 05403-000 Brazil Biostatistics Departament Biosciense Institute UNESP Botucatu SP 18618-689 Brazil Universidade Católica Portuguesa (UCP) Porto 4169-005 Portugal

The relational strategies in group are to improve patient’s BP （blood pressure） control and QoL （quality of life）. Methods： Twenty-one hypertensive patients were randomized into two groups： group A （10 patients, age 67 ± 6 years, BMI （body mass index） 28.3 ± 6 kg/m2） was applied relational strategies, with meetings every 15 days 8 meetings; group B （11 patients, age 58 ± 13 years, BMI 28.2 ± 3 kg/m2） with meetings for group orientation every 40 days 3 meetings. The patients were monitored： at baseline （day 15） and at the end of the study （day 120）, the BP was measured by auscultatory method and the QoL questionnaire （WHOQOL-BREF） was applied, and was submitted to the examination with ABPM （ambulatory blood pressure monitoring）. Results： after 120 days there was a greater （p 〈 0.05） reduction in SBP （systolic blood pressure） in group A （37.8 ± 25 mmHg） than in group B （18 ± 9 mmHg）, but DBP （diastolic blood pressure） decreased similarly in both groups （A, 15 ± 21 vs B, 13 ± 14 mmHg）; the HR （heart rate） reduction was larger （p 〈 0.05） in group A （60.6 ± 8.9 bpm） than in group B （69.7 ± 10.7 bpm）. There was a more significant BMI decrease （p 〈 0.01） in group A （27.8 ± 5 kg/m2） than in group B （28.9 ± 4 kg/m2）. The observed correlations between physical domain and nightime DBP （at day 120） in ABPM were r = -0.712 （negative correlation, p = 0.003）; between psychological domain and SBP sleep time （at day 120） in ABPM were r = -0.527 （negative correlation, p = 0.044）; between environmental domain and daytime Δ HR in ABPM were r = -0.573 （negative correlation, p = 0.007）. Conclusion： the health education program conducted through interpersonal relationships within groups provided better control of SBP and greater reduction in BMI.

关键词： Hypertension nursing health education adherence therapy

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