Day 1 :
- Hypertension and lifestyle disorders
DNP, FNP, BSN, RN, Lynchburg,
Heather Vasioutovitch has her passion in cardiology and in improving the health of each individual in a holistic way. This stems from her years of caring for cardiac patients as an RN and now as an ARNP- to seeing the essential need in addressing not only the physical parts of her patient’s health and wellbeing, but the mental, emotional, and spiritual aspects. She is involved in academia through online teaching and aims to continue spreading the importance of screening for depression in individuals with various cardiovascular diseases. Her goal is to increase researching in this specific area, ultimately changing the way providers care for their patients – always with the patients at the center.
In this scholarly project, the project leader implemented a chart audit and provider feedback intervention with the aim of improving provider referrals for patients who screened positive for depression—a risk factor in the myocardial infarction (MI) population—with the Patient Health Questionnaire-9 (PHQ-9). The clinical question was developed in order to examine whether the depression-screening tool that was implemented improved provider referrals to the in-house licensed counselor or primary care physician after an educational feedback intervention, focusing on physicians, nurse practitioners (NPs) and physician assistants (PAs). The target population involved cardiology providers and adult patients who experienced a MI, including Non-ST Segment Elevation Myocardial Infarctions (NSTEMIs) and ST Segment Elevation Myocardial Infarctions (STEMIs). The project was an evidence-based practice (EBP) project using a quasi-experimental design for purposes of auditing charts and offering educational performance feedback to the providers, with the aim of increasing referrals for patients, post-MI who screened positive for depression. A retrospective chart audit was conducted for the analyses to assess the number of referrals made for patients who screened positive for depression during scheduled follow-up visits. The providers were given an aggregate performance report that specified the findings of the group. The Two-Proportions Test and the Fisher’s Exact Test were applied, and demonstrated no statistical improvement between the pre- and post-intervention data. This project revealed significant clinical value to the practice setting. Provider knowledge, perceptions, and attitudes must be assessed as well as the need to target the nursing population.
King Fahad Medical City, Saudi Arabia
Dr. Ziauddin Ahmed is affiliated from King Fahad Medical City, Saudi Arabia.
Purpose of the study :
To raise awareness about the use of CAM especially Hibiscus tea and Yogurt among doctors and patients to prevent or treat hypertension .
Methods : Literature search with MEDLINE/ PubMed, International Journals,etc
DASH diet is already well known for hypertensive patients and the use of Yogurt also ( 2 servings/week) in a large Nurses’ Health Study with 55,898 female participants showed 17 % reduction and in Health Professionals Follow Up study with 18,232 males showed 21 % lower CVD risk among hypertensive patients.
Randomized control trials have also shown that use of Hibiscus tea has consistently reduced hypertension as effectively as Captopril but is found less effective than lisinopril. It is an antioxidant works also as a diuretic and in normal amounts has no adverse effects.
Conclusion and Significance : Literature has shown that both Hibiscus tea and Yogurt have been found to be successful in reducing Hypertension and it’s cardiovascular complications . It is very important to raise this awareness among physicians ( both allopathic and CAM ) and the people through mass media if need be to reduce morbidity and mortality.
The First Affiliated Hospital of Nanjing Medical Universtiyy, Nanjing, China
Dr. Li Jiang has completed her MD at the age of 35 years from Nanjing Medical University. She is a pediatric cardiologist (associate chief physician) in the field of stuctrual congenital heart disease. She has published more than 10 papers in reputed journals.
Omental adipose removal decreases high blood pressure in hypertensive patients independent of body mass index: It is a multicenter, prospective cohort clinical study. 133 patients with gastric or gynecological cancer were divided into 3 groups: non-hypertensive and omentum removed (NH&OR), hypertensive and omentum removed (H&OR), and hypertensive and omentum present (H&OP). The patients were followed up in sitting blood pressure (SBP), changes in related body mass index and metabolic indices. The time points of the 2 follow-up visits were 1 month ± 7 days after the operation before the start of chemotherapy and the endpoint of 8 ± 1 month. H&OR group showed significant reductions in SSBP and SDBP at 1-m (-16.94/-10.50 mmHg, both P < 0.001) and 8-m endpoint (-16.00/-5.50 mmHg, P < 0.001 and P = 0.004). Little reductions were observed with BMI of patients in 3 groups (H&OR group: 24.60 kg/m2 to 23.57 kg/m2, NH&OR group: 23.45 kg/m2 to 23.25 kg/m2, H&OP group: 25.74 kg/m2 to 25.24 kg/m2, all P > 0.05). No correlation was found between baseline BMI and 8-m change of SSBP and SDBP in H&OR groups. In both groups, triglyceride levels were significantly increased at 1-m after surgery (NH&OR 0.32 mmol/L, P = 0.006; H&OR 0.40 mmol/L, P = 0.010). Resection of omental adipose tissue represents an impact for reducing SSBP and SDBP at 8 months in hypertensive patients, even in the non-obese hypertensive population.
Shorooq Alherz is currently working in King Abdulaziz medical city of National guard hospital.
Hypertension, an epidemic affecting around one billion people worldwide, is the commonest risk factor for the increase in mortality rate. Because it is a major risk factor for coronary artery disease, stroke, heart failure, renal disease, and peripheral vascular disease, it constitutes a great public health concern. Primary or essential hypertension (EH) is the form that predominates in 90% of hypertension patients. The cause of elevated blood pressure in EH remains unknown. Evidence suggests that its causes are multiple and diverse, and considerable insight into those causes can be achieved by understanding the physiology of blood pressure control. If the elevation in blood pressure can be attributed to a definable cause, the hypertension is termed secondary hypertension. Although it is far less common than EH, conditions that cause secondary hypertension are important because many are amenable to permanent cure. Moreover, because elevated blood pressure is usually asymptomatic until an acute cardiovascular event strikes, assessment of risk factors and screening for hypertension is a critical for prevention. The presentation aims to arm the health worker with competencies in risk factor assessment and screening procedures. Early identification, modification of risk factors, and understanding the causative agents are important aspects in the prevention of the disease.