Compliance to antihypertensive therapy

To determine compliance, factors affecting compliance to antihypertensive therapy and to compare compliant and non-compliant groups, in a tertiary care setting. Analytical [cross-sectional] study. The outpatient clinics at the Aga Khan University from May 2004 to February 2005. Two hundred patients presenting to the outpatients clinic were included. All patients 18 years and above, who had stage 1 and 2 hypertension, had one clinic visit to a medicine clinic, 6 months prior to presentation and started on antihypertensive medicines, were included. Sixtysix percent were males and 33.5% were females. Mean age was 58.1[ +/- 12] years and mean duration of hypertension was 7.2 [ +/- 6.7] years. Fifty-seven percent were compliant and 43% were noncompliant. In the noncompliant group, 53.4% had mild noncompliance, 24.4% had severe non-compliance, while 22% had moderate noncompliance. Factors of noncompliance were 56.8% missed doses due to forgetfulness, 12.7% deliberately missed their doses, 11.6% could not take the medicine due to side effects, 10.4% did not take the dose due to increased number of tablets, 4.6% were not properly counseled by the physician and 3.48% did not take medicines due to cost issues. The mean systolic blood pressure was 126 +/- 19.2 mmHg in the compliant group while it was 133 +/- 16.5 mmHg in the noncompliant group [p-value 0.004]. The mean diastolic blood pressure in the compliant group was 76 +/- 11.9 mmHg, while in the noncompliant group it was 81.9 +/- 10.9 mmHg [p-value 0.001]. Compliance to antihypertensive therapy in a tertiary care center is significantly good. Forgetfulness was the major reason for noncompliance. The mean blood pressure control was better in the compliant group

Ventricular tachycardia: a hospital perspective

To describe the etiology and outcome in patients with ventricular tachycardia in our patient population. A descriptive study. The study was conducted at the Aga Khan University Hospital from November 2002 to October 2003. Subjects and We enrolled 58 patients who presented to the emergency room with clinical and electrocardiographic evidence of ventricular tachycardia [VT] and/or who developed it during the inpatient stay at the Aga Khan University Hospital. Medical records were retrieved through the computerized data retrieval system. Patients above 18 years of age were included. Those with a pacemaker or who developed VT during electrophysiological testing were excluded. A pre-designed proforma was filled for all patients who fulfilled the inclusion criteria. All patients were worked up for etiological causes of ventricular tachycardia. Outcomes in the form of death or discharge were recorded. There were 58 patients who suffered ventricular tachycardias during the study period. These included 70.7% [42] males and 29.3% [16] females. Mean age of the patients was 57.06 +/- 11.84 years. Emergency room admissions accounted for 55.2% and ventricular tachycardia was seen in 44.8% during the inpatient stay. Unresponsiveness was the presenting symptom in 25.9%, chest pain in 24.1%, palpitations in 13.8% and ghabrahat in 12.1% patients. Myocardial ischemia was seen in 43.5% of the patients while 23.2% had cardiomyopathy, followed by 33.3% miscellaneous. Out of the patients who had myocardial ischemia [43.5%], 76.6% had non-ST elevation myocardial infarction, 20% patients had ST elevation myocardial infarction and 3.3% had unstable angina. Hemodynamic instability was noted in 50%, who subsequently required defibrillation. The mortality among these patients with VT was 13.7%. Myocardial ischemia was most commonly seen in patients with ventricular tachycardia in our group of patients. Ventricular tachycardia is associated with a significant mortality of 13.7%