Asian management of hypertension: Current status, home blood pressure, and specific concerns in Vietnam.

Hypertension and atherosclerotic diseases are becoming important public health issues in Vietnam. This is due, in part, to changing dietary patterns and lifestyles accompanying economic growth in the country. The most recent prevalence data suggest that 29% of the population has hypertension, and the rate of other cardiovascular risk factors is also high. Although use of home and ambulatory blood pressure monitoring (HBPM and ABPM) is increasing, Vietnamese physicians generally rely on office blood pressure (BP) for diagnosing and managing hypertension. A lack of availability and training are limiting factors. However, out-of-office BP monitoring is important to detect white-coat and masked hypertension, and define the 24-hour BP profile. This approach is recommended in current Vietnam Society of Hypertension and Vietnamese National Heart Association guidelines. Based on 2016 data, the most commonly used antihypertensive agents in Vietnam are angiotensin-converting enzyme (ACE) inhibitors, followed by calcium channel blockers (CCBs) and diuretics, with ß-blockers and angiotensin receptor blockers used less frequently. Combination therapy, usually with an ACE inhibitor plus CCB or diuretic, is quite common (used in 62% of patients). The participation of Vietnam in global hypertension initiatives and organizations has likely contributed to improved treatment and control rates over the last 10 years. Nevertheless, the prevalence of hypertension remains high and additional strategies are needed to reduce this and prevent cardiovascular disease.

Imaging Characteristics of Mismatch Lesions: An Angiographic and Intravascular Ultrasound Analysis of 1369 Coronary Lesions.

OBJECTIVES: To evaluate the angiographic and intravascular ultrasound (IVUS) characteristics of coronary mismatch lesions. BACKGROUND: Better understanding about the characteristics of mismatch lesions may help to achieve more accurate lesion assessment and, thereby, to improve the outcomes of percutaneous coronary intervention (PCI). METHODS: Angiographic and IVUS data from 1369 lesions were analyzed. Mismatch lesion was defined as the difference between proximal and distal reference lumen diameters of ≥1.0 mm or ≥30% of the distal reference lumen diameter. RESULTS: The incidence of mismatch lesions was 20.1% (275/1369). Compared to nonmismatch group, mismatch group had longer lesions (21.3 [6.4] mm vs 18.4 [6.4] mm, P < .001) with smaller minimum lumen diameter (0.87 [0.29] mm vs 1.10 [0.31] mm, P < .001) and more severe diameter stenosis (78.8% [9.2%] vs 66.3% [10.3%], P < .001). On IVUS, mismatch group had larger lumen area (18.7 [5.0] vs 15.8 [5.1] mm2, P < .001) but lower plaque burden at the proximal reference segment (41.0% [9.2%] vs 45.7% [9.9%], P < .001) and smaller lumen area (4.83 [1.89] vs 7.36 [2.89] mm, P < .001) but higher plaque burden at the distal reference segment (42.9% [10.4%] vs 41.4% [10.1%], P = .023). Multivariable logistic regression analysis showed that mismatch lesions were frequently accompanied by diffuse lesions (odds ratio [OR] = 2.50; 95% confidence interval [CI]: 1.83-3.40; P < .001), bifurcation lesions (OR = 5.83; 95% CI: 4.40-7.74; P < .001), and lesions with a low TIMI flow grade (OR = 1.70; 95% CI: 1.08-2.67; P = .022) or severe diameter stenosis (OR = 3.05; 95% CI: 2.10-4.43; P < .001). CONCLUSIONS: Mismatch lesions are quite common and characterized by greater lesion complexity compared with nonmismatch lesions. Further studies may be necessary to address the impact of this lesion type on the outcome of PCI.

Motivation of university and non-university stakeholders to change medical education in Vietnam.

BACKGROUND: Both university and non-university stakeholders should be involved in the process of curriculum development in medical schools, because all are concerned with the competencies of the graduates. That may be difficult unless appropriate strategies are used to motivate each stakeholder. From 1999 to 2006, eight medical schools in Vietnam worked together to change the curriculum and teaching for general medical students to make it more community oriented. This paper describes the factors that motivated the different stakeholders to participate in curriculum change and teaching in Vietnamese medical schools and the activities to address those factors and have sustainable contributions from all relevant stakeholders. METHODS: Case study analysis of contributions to the change process, using reports, interviews, focus group discussions and surveys and based on Herzberg's Motivation Theory to analyze involvement of different stakeholders. RESULTS: Different stakeholders were motivated by selected activities, such as providing opportunities for non-university stakeholders to share their opinions, organizing interactions among university stakeholders, stimulating both bottom-up and top-down inputs, focusing on learning from each other, and emphasizing self-motivation factors. CONCLUSION: The Herzberg Motivation theory helped to identify suitable approaches to ensure that teaching topics, materials and assessment methods more closely reflected the health care needs of the community. Other medical schools undertaking a reform process may learn from this experience.

The measurements of some biochemical values of hypertensive adults in Xuan Canh Dong Anh Hanoi

Hypertension is increasing in the world including the Vietnam. Changes in concentrations of bood lipid, glucose are often correlated with hypertension. Changes in bood lipid concentration are major cause of cardiovascular disease. Finding and treatment of dyslipidemia in hypertensive patients will reduce cardiac complications. Objective: To detemnine serum total cholesterol, glucose, creatinine and urine protein, glucose in adults with hypertension and to find out the correlation between biochemical values and hypertension grades. Objects and method: 379 people with hypertension (grade 1: 221 people; grade 2: 134 people; grade 3: 24 people) and 86 people without hypertension served as control. This cross-sectional study was conducted from 12/2004-3/2005. Results: Biochemical values in people with hypertension were: total cholesterol: 4.75- 5.95 mmol/l; glucose: 4.83-5.11 mmol/l; creatinine: 69.22-89.02mmol/l. Urine protein test was positive in 6.3% of people with hypertesion. Values of total cholesterol, creatinine in people with grade-3 hypertension were significantly higher than these in normotensive people (p< 0.01). There were significantly regressed between diastolic blood pressure (DBP), systolic blood pressure (SBP) with creatinin (DBP: r=0.157 P< 0.01 ; Y=(0.101 X creatinin)+83.668 - SBP: r=0.113 P=0.02 Y= (0.127 X creatinin)+139.369.