ABSTRACT
Cardiovascular disease is one of the major causes of mortality in the world and chest pain is the most common symptoms of coronary atherosclerotic lesion or myocardial ischemia. This condition is the origin of readmission for coronary clients. To investigate the effect of the continuous consultation care model on hospitalization [readmission] and chest pain of coronary artery disease clients. This research was a clinical trial study in which the demographic, self report and check list questionnaires were used before and after the intervention in the two groups of experimental and control cases. A total number of 70 cases were equally divided into two groups and the continuous consultation care model was applied to the experimental group for a period of six months. In the same time, the control group was treated based on routine protocol. The results showed that the mean score of the hospitalizations or readmission before the study was 0.51 which decreased to 0.11 following the intervention in experimental group. In the control group, the mean scores were 0.57 and 0.34 before and after the study, respectively. The independent T test showed a significant difference between the two groups [P<0.03]. The mean score of the chest pain [coronary pain] during the study in the experimental and the control groups were 5 and 8 times, respectively. The independent T test and repeated measurements of ANOVA with [P<0.001] also showed a significant difference between experimental and control groups. The continuous consultation care model showed to affect the two variables of chest pain and readmission rates in coronary artery disease clients
Subject(s)
Humans , Coronary Artery Disease , Continuity of Patient Care , Patient Readmission , Surveys and Questionnaires , Clinical Trials as TopicABSTRACT
The "Tehran Blood Pressure Study" [TBPS] is an observational cross-sectional study performed on men and women aged 15 years or more during the years 1990-1991. The study has been designed and performed by the Tehran University of Medical Sciences' Cardiovascular Research Center, with the primary objective of determining the prevalence and distribution of high blood pressure in Tehran! adults, hi addition, awareness levels, control rates, and the prevalence of other cardiovascular risk factors among those with high blood pressure, as well as associations between blood pressure [BP] levels and certain epidemiologic and anthropometric factors have been studied. The study population comprised 10180 male and female inhabitants of Tehran aged above 15, selected by random sampling in 50 districts of the city. The mean and the 95% confidence interval for systolic blood pressure [SBP] and diastolic blood pressure [DBP] were 123 [122.8-123.4] and 75.4 [75.2-75.6], respectively. The prevalence of high blood pressure [SBP >/= 140 mmHg or DBP> 90 mmHg or drug consumption] was 17.6% in males, 17.9% in females, and 17.7% in general. About 47% of the patients with high DBP readings were aware of their condition. In 20% of these, control of hypertension had been achieved by drug therapy; in 11%, drug therapy had failed to control hypertension, and 16% were not receiving treatment despite their awareness. High body mass index and a history of diabetes were more frequent in those with high BP readings than the general population. Of those with high BP readings, most had only mild elevations of BP [90 /= 140 mm Hg and DBP< 90 mmHg] was found in 36% of females and 30% of males aged above 64. The noticeable prevalence of high BP, the remarkable prevalence of isolated high systolic blood pressure in the elderly, the very low level of patient awareness and low control rates all necessitate the adoption of appropriate personal and community health policies
Subject(s)
Myocardial IschemiaABSTRACT
The "Comparative Study of Antihypertensive Treatments"-CSAT is a placebo-controlled, randomized, double-blind clinical trial, with the primary objective of comparing the efficacy of different pharmacological treatments of hypertension. Drug side-effects, patient compliance, and alterations in the patients' quality of life are also compared. Subjects with mild to moderate diastolic hypertension aged above 30 are randomized into either of 5 groups receiving methyldopa, atenolol, nifedipine, triamterene-H, or placebo. After a dose titration phase, the minimum drug dose required to achieve a therapeutic goal of less than 91 mmHg for diastolic blood pressure [DBF] is determined, and the patient then enters a maintenance phase of 6 months. This report presents the preliminary results of drug efficacy in 136 subjects who have completed the dose titration phase. Age, sex, baseline systolic blood pressure [SBP] and baseline DBP were all well balanced across placebo and drug groups: mean age +/- SD -51.9 +/- 9.2 years; sex distribution; 56.6% males: mean DBP +/- SD= 98.5 +/- 5.4 mmHg: mean SBP +/- SD= 152.1 +/- 14.4 mmHg: [SD = standard deviation, SBP and DBP values were measured in the sitting position]. SBP and DBP reduction in the active treatment groups [mean +/- SE: 17.8 +/- 1.4 mmHg for SBP, 12.4 +/- 0.7 rnmHg for DBP] were significantly greater than in the placebo group [mean +/- SE: 7.9 +/- 1.6 mmHg for SBP, 7.23 +/- 0.9 mmHg for DBP] at the end of the dose titration phase [P < 0.00001]. There was greater SBP reduction with atenolol 23.9 +/- 3.2 mmHg] than with either nifedipine [12.5 +/- 2.3 mmHg] or triamterene-H [16.2 +/- 2.7 mmHg], P<0.05. This difference was not observed in patients aged above 50, but was significant in the below 50 age group. Pharmacological treatment was more efficacious in SBP reduction in women than in men [22 +/- 2,1 mmHg in women versus 14.0 +/- 1.7 mmHg in men, P<0.01]- No similar difference between the two sexes was detected in the placebo group. This interim report of the CSAT emphasizes the importance of pharmacological therapy, and depicts significant differences in the antihypertensive efficacy of various drug groups. Establishing new research centers and reaching desired sample sizes are currently being undertaken