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Objective To screen the incidence of transient hypertension in conventional hypertensive management population of hypertension and analysis it's related etiology and constituent ratio.Methods People who met the diagnosis of hypertension were selected from inpatient and outpatient of this department.All patients were followed up for 2 months of home blood pressure monitoring,if the patients who were normal when monitoring home blood pressure were included in the trial and symptomatic hypertension was excluded.Results Three hundred of patients met the diagnostic criteria for hypertension,46 cases (15.3％) met the standard of transient hypertension,the etiology and constituent ratio of transient hypertension in the observed cases were as follows:25 cases (54.3％) of anxiety and depression,8 cases (17.4％) of acute cerebrovascular disease,7 cases (15.2％) of sleep disorders,4 cases(8.7％) of a variety of head and face pain,1 (2.2％)case of epilepsy tonic clonus,1 (2.2％)case of vertigo.Conclusion The application of interactive management of home blood pressure measurement is particularly helpful for screening patients with transient hypertension,and it can timely avoid excessive anti-hypertensive treatment.
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Objective To evaluate the effectiveness of internet-based cognitive behavior therapy (CBT-I) on blood pressure in patients with hypertension comorbid with insomnia.Methods One hundred and six patients met the JNC-8 diagnostic criteria for hypertension and DSM-5 diagnostic criteria for insomnia were selected,and randomly assigned to CBT-I group (n=53) and regular treatment group (n=53).All the patients accepted relevant treatment for 8 consecutive weeks.Changes of systolic blood pressure (SBP),diastolic blood pressure (DBP),the sleep parameters and the anxiety and depression levels were observed between baseline and 8 weeks of follow-up.Results Compared with pre-treatment,SBP and DBP decreased significantly in both CBT-I group and regular treatment group (P＜0.01),the decrease was more significant in CBT-I group than in regular treatment group (P＜0.01).The sleep latency,sleep efficiency,bed time and rating anxiety scale were improved more significantly in CBT-I group than in regular treatment group (44.49 ± 22.75min vs.55.50 ± 34.96min;72.31％ ± 9.15％ vs.57.70％ ± 11.53％;302.65 ± 43.76min vs.262.70 ± 50.64min and 17.14 ± 6.45 vs.21.02 ± 6.64,respectively),the differences were of statistical significance (P＜0.05).In addition,no significant difference was found in the level of depression between CBT-I group and regular treatment group.Conclusion CBT-I can effectively shorten sleep latency,improve sleep efficiency,extend bed time and improve anxiety,meanwhile effectively lower the blood pressure of patients with hypertension comorbid with insomnia by optimizing sleep quality.
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Objective To evaluate the clinical significance of improving the goal attainment rate by management of timely feedback of hypertension patients, which is carried out by using existing communication network. Methods Totally 423 hypertension patients who were hospitalized for treatment in Daping Hospital from Jan. 2012 to Jan 2013, the random numbers table was used to randomize the patients into 2 groups: control group (212 cases) and experiment group (211cases), the conventional treatment was used in control group. Besides the conventional treatment measures, the modern way of communication and network information platform was used by patients who timely feed back the blood pressure changing, and implement the cognitive treatment of hypertension at the same time in the experiment group. The Chi square test was used to compare the patient's medication compliance, the attainment rate and so on , the t test was used to compare the blood pressure in two groups of patients after the intervention. Results At the end of the intervention, the difference of heavy salt diet (reduced to 16.59%), regularly drinking (reduced to 13.74%), heavy sugar diet (reduced to 10.43%), abnormal blood lipid (reduced to 19.91%), smoking (reduced to 27.96%), the number of people who have a stable mood (up to 91.47%), body mass index (reduced to 29.38%) and exercise at ordinary times (reduced to 36.02%) were statistically significant (P< 0.05). Hypertension patients compliance increased significantly, of which the medical behavior of 84.83%, compared with 13.21%in the control group, there was statistically significant difference (χ 2=8.54,P< 0.05). And the awareness, treatment, success rate of blood pressure control were 94.79%, 84.36%, 82.94% in experimental group and 50.94%, 40.09%, 27.83% in control group, and the differences were statistically significant (P<0.05). Conclusion Use of the existing information interaction platform in order to strengthen the management of the blood pressure of hypertension patients and related cognitive behavioral intervention, the control of risk factors and treatment compliance have improved significantly. The remote interaction platform used to patients with hypertension management improve the attainment rate of high blood pressure.
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Objective To assess the effect of remote-interactive cognitive behavioral therapy in pa-tients with chronic insomnia.Methods A total of 62 patients with chronic insomnia were randomly divided into combined treatment group,cognitive behavioral therapy for insomnia ( CBTI) group and drug treatment group.The study lasted for 6-8 weeks.The curative effects were assessed using sleep diary and scales.Results The sleep onset latency (SOL) ((39.9±23.7)min) and wake time after sleep onset(WASO) ((79.1± 39.4) min) in the drug treatment group were higher than that in the combined treatment group ( ( 25.5 ± 11.2)min and (54.4±38.5)min,respectively) and CBTI group ((27.8±11.6)min and (51.8±29.0)min,re-spectively) at the end of treatment,the difference was statistical significance( P=0.018 and P=0.046 respec-tively).The sleep efficiency(SE) in drug treatment ((76.5±11.9)%) was lower than that in the other two groups((83.8±8.7)%and (82.8±7.0)%respectively),(P=0.042).And no similar difference were seen in TST after treatment(P>0.05).The Brief Version of Dysfunctional Beliefs and Attitudes about Sleep(DBAS-16) score in the drug treatment group (97.6±16.4) was higher than the other two groups((67.5±20.1) and ( 75.0±26.9) respectively) after treatment(P=0.000) .No significant difference was seen in scores of the oth-er scales among the three groups(P>0.05) .After treatment,a greater proportion of patients in the combined treatment group had withdrawn from hypnotics use completely (29%(6/20) vs 5%(1/18);odds ratio( OR ) was 7.286);and the combined treatment group produced significant reduction in frequency of hypnotics use ((3.35±3.05) nights/week) when compared with drug treatment group((5.56±2.33) nights/week, P=0.016) .Conclusions Remote-interactive cognitive behavioral therapy was effective and acceptable for treating pa-tients with chronic insomnia,combining drug treatment in the early period could quickly relieve the symptoms of in-somnia,and can avoid the adverse effect from the hypnotics.And the treatment method can reduce the dropout rate.
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Objective To explore the correlation between oxygen reduction index(ODI) with blood lipid and renal function in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) .Methods Selected 208 patients by polysomnography (PSG) and diagnosed as OSAHS ,divided into four groups according to ODI(ODI ≤ 7 ,7 38) .Four groups were compared in total cholesterol (TC) ,triglyceride (TG) ,high‐density lipoprotein cholesterol (HDL‐C) ,low density lipo‐protein cholesterol (LDL‐C) ,apolipoprotein A1 (ApoA1) ,apolipoprotein B (ApoB) ,urea ,creatinine ,uric acid and other differ‐ences ,analysis the correlation between ODI with blood lipid and renal function .Results There were significant different in TC ,TG , HDL‐C ,LDL‐C ,ApoB ,urea ,creatinine ,uric acid in four groups with different degree of ODI (P< 0 .05) ;ODI were positively relat‐ed to TC ,TG ,LDL‐C ,ApoB ,urea ,creatinine ,uric acid levels ,and negatively related to the level of HDL‐C .Conclusion Abnormity of blood lipid metabolic and changes in renal function are associated with the increase of ODI in patients with OSAHS .