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Major adverse effects of antihypertensive medicines a 

Major adverse effects of antihypertensive medicines a 

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For the effective management of hypertension, drug adherence and life style modification are important. We investigated the effects of mobile phone text-message reminders on compliance and life style modification in patients with hypertension.

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... choosing an antihypertensive drug therapy, there are a number of specifi c compelling indi- cations (Table 7). In the absence of any compelling indication, and of major adverse effects (Table 8), currently available evidence from comparative trials of effi cacy and cardiovascular outcomes supports the use of any one of the following classes of drugs as initial therapy: ACE inhibitor, calcium-channel blocker, or low-dose diuretic. Beta-blockers should be considered for fi rst-line antihypertensive therapy only if there is a compelling indication (294-296) ( Table 7). ...

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... Health-coaching is becoming an increasingly popular means of improving chronic diseases (9). However, the only studies conducted in Korea include one in which participants measured their BP and sent these measurements via text messages (7), and one wherein only five text messages that included health information were used over a 12-week period (10); this shows that there is a severe lack of research examining the use of text messaging among patients with hypertension. Furthermore, only one study has examined the effects of phone-based health-coaching on patients with hypertension in Korea (11). ...
Article
Background: We aimed to develop long-message services (LMS) and phone-based health-coaching for community-dwelling seniors diagnosed with hypertension and assess the effects of the programs implemented both separately and together. These programs are easily applicable to seniors diagnosed with hypertension and will help control their blood pressure (BP) in a practical manner. Methods: We conducted a single-blinded, randomized, controlled pragmatic trial. Individuals aged 65 years or older with hypertension at two senior welfare centers in Seoul, South Korea, who were able to take phone calls and check text messages were enrolled. The study included 124 participants: 31 in the control group, 30 in the health-coaching group, 32 in the LMS group, and 31 in the health-coaching-with-LMS group. Results: Phone-based health-coaching with LMS was effective in improving medication adherence, hypertension self-efficacy, and self-management behavior and decreasing systolic BP as compared to LMS only. There were also improvements in medication adherence, hypertension-related knowledge, hypertension self-efficacy, self-management behavior, and systolic BP in the LMS group as compared to the control group. Conclusion: Using phone-based health-coaching with LMS was effective for managing hypertension in community-dwelling seniors diagnosed with hypertension and could become a useful intervention method.
... A total score of >18 for men and >16 for women was defined as high salt usage behavior. 12,13) Concomitant medication was assessed as per medications taken by the patient at the time of the survey. ...
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Background: Hypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication. Methods: From August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable. Results: Of the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ≥65 years, exercise, treatment in a metropolitan-located hospital, being on ≥2 classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication. Conclusion: Multiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.
... These devices were used in conjunction with mobile technology often through wireless or USB sharing. Four of the more recent studies utilized smartphone applications as the mode of delivery [15][16][17][18], and three of the interventions described SMS as their mode of delivery [19][20][21] ( Table 2). The framework of self-management has three dimensions, including context, process, and outcomes. ...
... A total of 6 studies measured dietary behavior/intake, outpatient attendance, health knowledge, medication adherence, self-care behavior, self-efficacy, and social support as proximal outcomes of interventions that directly influenced selfmanagement behaviors [15,17,19,[21][22][23]. Changes in distal outcomes, such as glucose level, blood pressure, fat level, and body size and composition were obtained in 13 studies. ...
... Changes in distal outcomes, such as glucose level, blood pressure, fat level, and body size and composition were obtained in 13 studies. Three studies out of the 13 studies additionally measured patient reported outcome measures (PROMs), such as quality of life, treatment acceptance, and patient satisfaction [16][17][18][20][21][22][23][24][25][26][27][28][29]. Even though the study results appeared to be inconsistent, 11 studies reported a statistically significant beneficial effect of mHealth intervention, which improved at least one outcome measure. ...
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Objectives Population aging has increased the burden of chronic diseases globally. mHealth is often cited as a viable solution to enhance the management of chronic conditions. In this study, we conducted a systematic review of mHealth interventions for the self-management of chronic diseases in Korea, a highly-connected country with a high chronic care burden. Methods Five databases were searched for relevant empirical studies that employed randomized controlled trial (RCT) or quasi-experimental methods published in English or Korean from the years 2008 to 2018. The selected studies were reviewed according to the PRISMA guidelines. The selected studies were classified using the Individual and Family Self-Management Theory conceptual framework. Results Sixteen studies met the inclusion criteria, 9 of which were targeted towards diabetes management, and 7 of which were RCTs. Other target diseases included hypertension, stroke, asthma, and others. mHealth interventions were primarily delivered through smartphone applications, mobile phones connected to a monitoring device, and short message services (SMS). Various self-management processes were applied, including providing social influence and support, and facilitating self-monitoring and goal setting. Eleven studies showed mHealth interventions to be effective in improving self-management behaviors, biomarkers, or patient-reported outcome measures associated with chronic diseases. Conclusions While the number of identified studies was not large, none reported negative impacts of mHealth on selected outcomes. Future studies on mHealth should design interventions with a greater variety of targeted functions and should adopt more rigorous methodologies to strengthen the evidence for its effectiveness in chronic disease management.
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Background Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents. Methods This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients' lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mm Hg diastolic. Results Of the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt intake also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, education, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control. Conclusion Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.