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El Kardoudi A, Chetoui A, Kaoutar K, Boutahar K, Elmoussaoui S, Chigr F, Najimi M. [Factors associated with poor blood pressure control in Moroccan hypertensive patients]. Ann Cardiol Angeiol (Paris) 2022; 71:141-147. [PMID: 35039140 DOI: 10.1016/j.ancard.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/10/2021] [Indexed: 10/19/2022]
Abstract
STUDY AIM Hypertension is a major public health concern worldwide and non-controlling it can lead to various cardiovascular complications. Controlling blood pressure and reducing overall cardiovascular risk are two main goals of treatment. Thus, this study aimed to determine the proportion and factors associated with uncontrolled hypertension in hypertensive patients living in the Beni Mellal city. PATIENTS AND METHODS The cross-sectional survey took place between June and March 2019. It involved 580 hypertensive patients attending the primary health care facilities in Beni Mellal city, using systematic sampling. RESULTS A total of 580 hypertensive patients were recruited, with a mean age of 55.78 (± 10.82 years) and of which 66.89% were female. The proportion of poor blood pressure control was 74.1% and was associated in multivariate analysis with a family history of hypertension(OR = 1.60; 95% CI = [1.02-2.50]), dyslipidemia (OR = 2.05; 95% CI = [1.32 -3.20]), non-adherence to a regular BP measurement (OR = 4.13; 95% CI = [2.49 -6.86]), to treatment (OR = 3.64; 95% CI = [2.34-5.65]) and regular biological monitoring (OR = 2.45; 95% CI = [1.46-4.08]). CONCLUSION Despite the free and available of treatment, the proportion of uncontrolled hypertension was high. This might be linked to a lack of awareness and education concerning disease self-management.
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Affiliation(s)
- A El Kardoudi
- Laboratoire de Génie Biologique, Faculté des Sciences et Techniques, Université Sultan Moulay Slimane, 23000, B.P : 523, Beni Mellal, Maroc, Téléphone : + 212 (0) 523 48 51 12/22/82, Fax : +212 (0) 523 48 52 01, E-mails : .
| | - A Chetoui
- Laboratoire de Génie Biologique, Faculté des Sciences et Techniques, Université Sultan Moulay Slimane, 23000, B.P : 523, Beni Mellal, Maroc, Téléphone : + 212 (0) 523 48 51 12/22/82, Fax : +212 (0) 523 48 52 01, E-mails :
| | - K Kaoutar
- Laboratoire de Génie Biologique, Faculté des Sciences et Techniques, Université Sultan Moulay Slimane, 23000, B.P : 523, Beni Mellal, Maroc, Téléphone : + 212 (0) 523 48 51 12/22/82, Fax : +212 (0) 523 48 52 01, E-mails :
| | - K Boutahar
- Laboratoire de Génie Biologique, Faculté des Sciences et Techniques, Université Sultan Moulay Slimane, 23000, B.P : 523, Beni Mellal, Maroc, Téléphone : + 212 (0) 523 48 51 12/22/82, Fax : +212 (0) 523 48 52 01, E-mails :
| | - S Elmoussaoui
- Laboratoire de Génie Biologique, Faculté des Sciences et Techniques, Université Sultan Moulay Slimane, 23000, B.P : 523, Beni Mellal, Maroc, Téléphone : + 212 (0) 523 48 51 12/22/82, Fax : +212 (0) 523 48 52 01, E-mails : ; Centre Hospitalier Universitaire Mohamed VI, BP 2360 Principal، Avenue Ibn Sina, Marrakech, Maroc
| | - F Chigr
- Laboratoire de Génie Biologique, Faculté des Sciences et Techniques, Université Sultan Moulay Slimane, 23000, B.P : 523, Beni Mellal, Maroc, Téléphone : + 212 (0) 523 48 51 12/22/82, Fax : +212 (0) 523 48 52 01, E-mails :
| | - M Najimi
- Laboratoire de Génie Biologique, Faculté des Sciences et Techniques, Université Sultan Moulay Slimane, 23000, B.P : 523, Beni Mellal, Maroc, Téléphone : + 212 (0) 523 48 51 12/22/82, Fax : +212 (0) 523 48 52 01, E-mails :
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Cárdenas-Valladolid J, López-de Andrés A, Jiménez-García R, de Dios-Duarte MJ, Gómez-Campelo P, de Burgos-Lunar C, San Andrés-Rebollo FJ, Abánades-Herranz JC, Salinero-Fort MA. Effectiveness of standardized nursing care plans to achieve A1C, blood pressure, and LDL-C goals among people with poorly controlled type 2 diabetes mellitus at baseline: four-year follow-up study. BMC FAMILY PRACTICE 2018; 19:125. [PMID: 30041600 PMCID: PMC6058384 DOI: 10.1186/s12875-018-0800-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 06/21/2018] [Indexed: 11/22/2022]
Abstract
Background No studies that have measured the role of nursing care plans in patients with poorly controlled type 2 diabetes mellitus. Our objectives were firstly, to evaluate the effectiveness of implementing Standardized languages in Nursing Care Plans (SNCP) for improving A1C, blood pressure and low density lipoprotein cholesterol (ABC goals) in patients with poorly controlled type 2 diabetes mellitus at baseline (A1C ≥7%, blood pressure ≥ 130/80 mmHg, and low-density lipoprotein cholesterol≥100 mg/dl) compared with Usual Nursing Care (UNC). Secondly, to evaluate the factors associated with these goals. Methods A four-year prospective follow-up study among outpatients with type 2 diabetes mellitus: We analyzed outpatients of 31 primary health centers (Madrid, Spain), with at least two A1C values (at baseline and at the end of the study) who did not meet their ABC goals at baseline. A total of 1916 had A1C ≥7% (881 UNC versus 1035 SNCP). Two thousand four hundred seventy-one had systolic blood pressure ≥ 130 mmHg (1204 UNC versus 1267 SNCP). One thousand one hundred seventy had diastolic blood pressure ≥ 80 mmHg (618 UNC versus 552 SNCP); and 2473 had low-density lipoprotein cholesterol ≥100 mg/dl (1257 UNC versus 1216 SNCP). Data were collected from computerized clinical records; SNCP were identified using NANDA and NIC taxonomies. Results More patients cared for using SNCP achieved in blood pressure goals compared with patients who received UNC (systolic blood pressure: 29.4% versus 28.7%, p = 0.699; diastolic blood pressure: 58.3% versus 53.2%, p = 0.08), but the differences did not reach statistical significance. For A1C and low-density lipoprotein cholesterol goals, there were no significant differences between the groups. Coronary artery disease was a significant predictor of blood pressure and low-density lipoprotein cholesterol goals. Conclusions In patients with poorly controlled type 2 diabetes mellitus, there is not enough evidence to support the use of SNCP instead of with UNC with the aim of helping patients to achieve their ABC goals. However, the use of SNCP is associated with a clear trend of a achievement of diastolic blood pressure goals.
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Affiliation(s)
- J Cárdenas-Valladolid
- Dirección Técnica de Sistemas de Información, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, C/ San Martín de Porres, 6, 28035, Madrid, Spain. .,Universidad Alfonso X el Sabio, Villanueva de la Cañada, Madrid, Spain. .,Aging and Fragility in the Elderly Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain. .,MADIABETES Research Group, Madrid, Spain.
| | - A López-de Andrés
- MADIABETES Research Group, Madrid, Spain.,Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - R Jiménez-García
- MADIABETES Research Group, Madrid, Spain.,Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - M J de Dios-Duarte
- Jefatura de Estudios del Grado en Enfermería, Universidad Alfonso X el Sabio, Villanueva de la Cañada, Madrid, Spain
| | - P Gómez-Campelo
- Aging and Fragility in the Elderly Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,MADIABETES Research Group, Madrid, Spain.,Innate Immunity Group, Hospital La Paz Institute for Health Research (IdiPAZ), La Paz University Hospital, Madrid, Spain.,University Centre of Health Sciences San Rafael-Nebrija, Antonio de Nebrija University, Madrid, Spain
| | - C de Burgos-Lunar
- Aging and Fragility in the Elderly Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,MADIABETES Research Group, Madrid, Spain.,Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.,Dirección General de Salud Pública, Subdirección de Promoción, Prevención y Educación de la Salud, Consejería de Sanidad, Madrid, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | | | - J C Abánades-Herranz
- Aging and Fragility in the Elderly Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,MADIABETES Research Group, Madrid, Spain.,Centro de Salud Monóvar, Madrid, Spain
| | - M A Salinero-Fort
- Aging and Fragility in the Elderly Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,MADIABETES Research Group, Madrid, Spain.,Dirección General de Salud Pública, Subdirección de Promoción, Prevención y Educación de la Salud, Consejería de Sanidad, Madrid, Spain.,Subdirección General de Investigación. Consejería de Sanidad, Madrid, Spain
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Kengne AP, Libend CN, Dzudie A, Menanga A, Dehayem MY, Kingue S, Sobngwi E. An assessment of discriminatory power of office blood pressure measurements in predicting optimal ambulatory blood pressure control in people with type 2 diabetes. Pan Afr Med J 2014; 19:231. [PMID: 25838859 PMCID: PMC4377096 DOI: 10.11604/pamj.2014.19.231.2608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 02/04/2014] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Ambulatory blood pressure (BP) measurements (ABPM) predict health outcomes better than office BP, and are recommended for assessing BP control, particularly in high-risk patients. We assessed the performance of office BP in predicting optimal ambulatory BP control in sub-Saharan Africans with type 2 diabetes (T2DM). METHODS Participants were a random sample of 51 T2DM patients (25 men) drug-treated for hypertension, receiving care in a referral diabetes clinic in Yaounde, Cameroon. A quality control group included 46 non-diabetic individuals with hypertension. Targets for BP control were systolic (and diastolic) BP. RESULTS Mean age of diabetic participants was 60 years (standard deviation: 10) and median duration of diabetes was 6 years (min-max: 0-29). Correlation coefficients between each office-based variable and the 24-h ABPM equivalent (diabetic vs. non-diabetic participants) were 0.571 and 0.601 for systolic (SBP), 0.520 and 0.539 for diastolic (DBP), 0.631 and 0.549 for pulse pressure (PP), and 0.522 and 0.583 for mean arterial pressure (MAP). The c-statistic for the prediction of optimal ambulatory control from office-BP in diabetic participants was 0.717 for SBP, 0.494 for DBP, 0.712 for PP, 0.582 for MAP, and 0.721 for either SBP + DBP or PP + MAP. Equivalents in diabetes-free participants were 0.805, 0.763, 0.695, 0.801 and 0.813. CONCLUSION Office DBP was ineffective in discriminating optimal ambulatory BP control in diabetic patients, and did not improve predictions based on office SBP alone. Targeting ABPM to those T2DM patients who are already at optimal office-based SBP would likely be more cost effective in this setting.
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Affiliation(s)
- Andre Pascal Kengne
- South African Medical Research Council & University of Cape Town, Cape Town, South Africa
| | | | - Anastase Dzudie
- Service of Internal Medicine, General Hospital of Douala, Douala, & Buea faculty of Health Sciences, Buea, Cameroon
| | - Alain Menanga
- Service of Medicine A, General Hospital of Yaounde, Yaounde, Cameroon
| | | | - Samuel Kingue
- Service of Medicine A, General Hospital of Yaounde, Yaounde, Cameroon
| | - Eugene Sobngwi
- Diabetes and Endocrine service, Yaounde Central Hospital, Yaounde, Cameroon
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Mesli MF, Raïah M, Mohammedi B, Dida A. [Factors associated with poor blood pressure control in 253 treated hypertensive patients]. Ann Cardiol Angeiol (Paris) 2014; 64:32-8. [PMID: 24856658 DOI: 10.1016/j.ancard.2014.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 04/08/2014] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Hypertension is a major public health problem throughout the world. The blood pressure control and the decrease of global cardiovascular risk are two main goals of the treatment of hypertension. The purpose of this study was to determine the proportion and associated factors of uncontrolled hypertension in hypertensive patients followed by private cardiologists in Oran. MATERIALS AND METHODS This study included 253 hypertensive patients followed by 7 private cardiologists in Oran. Was regarded as uncontrolled high blood pressure, a systolic blood pressure (SBP) superior or equal to 140 mmHg and/, or a diastolic blood pressure (DBP) superior or equal to 90 mmHg. A logistic regression analysis was performed to determine the associated factors with poor blood pressure control. RESULTS The proportion of uncontrolled hypertension was 69.6 % (75.8 % of men and 65.8 % of women). Using multivariate analysis, poor blood pressure control was found to be associated with salt consumption (ORa=2.71; CI 95 %=[1.42-5.18]). CONCLUSION Nutritional actions are required for better blood pressure control.
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Affiliation(s)
- M F Mesli
- Laboratoire de biostatistique, faculté de médecine Oran, BP 1510, 31000 Oran El M'Naouer, Algérie.
| | - M Raïah
- Laboratoire de biostatistique, faculté de médecine Oran, BP 1510, 31000 Oran El M'Naouer, Algérie
| | - B Mohammedi
- Laboratoire de biostatistique, faculté de médecine Oran, BP 1510, 31000 Oran El M'Naouer, Algérie
| | - A Dida
- Laboratoire de biostatistique, faculté de médecine Oran, BP 1510, 31000 Oran El M'Naouer, Algérie
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Diyane K, El Ansari N, El Mghari G, Anzid K, Cherkaoui M. [Characteristics of the association type 2 diabetes and hypertension in the elderly aged 65 and over]. Pan Afr Med J 2013; 14:100. [PMID: 23717715 PMCID: PMC3664871 DOI: 10.11604/pamj.2013.14.100.1880] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 11/01/2012] [Indexed: 11/15/2022] Open
Abstract
Introduction L'HTA du diabétique âgé est particulière par sa fréquence et sa gravité. Cette association HTA-diabète type 2 (DT2) est particulièrement fréquente chez la personne âgée, et responsable d'une majoration du risque cardiovasculaire et d'une accélération de l'atteinte dégénérative du diabète. Méthodes Etude descriptive, concernant 100 patients diabétiques de type 2 hypertendus âgés de 65 ans ou plus, suivis au service d'endocrinologie-diabétologie du CHU de Marrakech, du mois de Novembre 2010 au mois de Juillet 2011. Le logiciel SPSS version 18 a été utilisé pour l'analyse statistique. Résultats Le sex-ratio des patients étudiés était de 0,26, l’âge moyen était de 69,2 ±; 4,3 ans, l'ancienneté du diabète était de 9,3 ±; 6,7 ans. Le diagnostic du diabète précédait celui de l'HTA dans 67,7% des cas. Seulement 4,2% avaient une HbA1c ≤ 6,5%. 60% des patients avaient une HTA de grade I. L'IMC moyen était de 28,1 ±; 4,6 kg/m2. La dyslipidémie était présente chez 59,6% de nos patients avec essentiellement une hypoHDLémie (75,9%). La macroangiopathie était observée chez 40% des patients avec essentiellement une cardiopathie ischémique (29%). Elle était significativement plus fréquente chez les patients ayant une HbA1c supérieure à 9%, LDL-c ≥ 1 g/l et une hypoHDLémie. La microangiopathie présente dans 82% des cas était significativement en relation avec l'HbA1c, le DFG et le taux des triglycérides. Conclusion Une prise en charge complète du risque cardio-vasculaire chez les sujets âgés se heurte à des problèmes objectifs en pratique courante, en particulier, la polymédication, source d'une mauvaise compliance et donc de mauvais résultats. Mots clés: Complications dégénératives, Diabète type 2, Dyslipidémie, Hypertension artérielle, Sujet âgé.
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Affiliation(s)
- Khadija Diyane
- Service d'endocrinologie, diabétologie et maladies métaboliques, Laboratoire de recherche de pneumo-cardio-immunopathologie et métabolisme PCIM, Faculté de Médecine et de Pharmacie de Marrakech, Université cadi Ayyad. CHU Mohamed VI. Rue el mostachfa, Gueliz, 40 000, Marrakech, Maroc
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