Evaluation of plasma vitamin E and development of proteinuria in hypertensive patients

Background

The prospective relationship between plasma vitamin E levels and proteinuria remains uncertain. We aimed to evaluate the association between baseline plasma vitamin E levels and the development of proteinuria and examine any possible effect modifiers in patients with hypertension.

Methods

This was a post hoc analysis of the renal sub-study of the China Stroke Primary Prevention Trial (CSPPT). In total, 780 participants with vitamin E measurements and without proteinuria at baseline were included in the current study. The study outcome was the development of proteinuria, defined as a urine dipstick reading of a trace or ≥ 1+ at the exit visit.

Results

During a median follow-up duration of 4.4 years, the development of proteinuria occurred in 93 (11.9%) participants. Overall, there was an inverse relationship between plasma vitamin E and the development of proteinuria (per standard deviation [SD] increment; odds ratio [OR]: 0.73, 95% confidence interval [CI]: 0.55-0.96). Consistently, when plasma vitamin E was assessed as quartiles, lower risk of proteinuria development was found in participants in quartiles 2-4 (≥ 7.3 μg/mL; OR: 0.57, 95% CI: 0.34-0.96) compared to those in quartile 1. None of the variables, including sex, age, and body mass index, significantly modified the association between vitamin E and proteinuria development.

Conclusion

There was a significant inverse association between plasma vitamin E levels and the development of proteinuria in patients with hypertension. The results were consistent among participants with different baseline characteristics.

The effect of educational intervention in the prevention of cardiovascular diseases in patients with hypertension with application of health belief model: A quasi-experimental study

Background

The best methods for preventing and controlling cardiovascular diseases are preventive behaviours.

Aim

The purpose of the current study is to ascertain how educational intervention affects cardiovascular disease prevention.

Methods

The current investigation is a quasi-experimental study conducted in Shiraz, Iran, in the year 2022, focusing on 200 hypertension patients (by sample random sampling) that were divided into two groups: a control group consisting of 100 participants (63 males and 37 females) and an intervention group also consisting of 100 participants (58 males and 42 females). The data collection instrument comprises inquiries pertaining to demographic factors as well as constructs of the health belief model (HBM) and preventive behaviours for cardiovascular diseases. The participants in both groups completed the questionnaire prior to and three months after the intervention. The intervention group underwent a total of six training sessions, each lasting 55 min.

Results

The results showed that after the intervention, the intervention group showed a significant increase in all cues of the HBM model except for the perceived barriers. Following a period of three months subsequent to the educational intervention, the experimental group also exhibited a notable reduction in blood pressure in comparison to the control group.

Conclusion

The findings of the study indicate that the utilisation of the HBM demonstrated positive outcomes in facilitating the promotion of cardiovascular disease prevention among patients diagnosed with hypertension. The promotion of health among individuals with high blood pressure can be both beneficial and feasible. Moreover, this particular model can be utilised as a comprehensive framework for the development, execution, and evaluation of advantageous and effective healthcare initiatives.

Multidimensional Feature Classification of the Health Information Needs of Patients With Hypertension in an Online Health Community Through Analysis of 1000 Patient Question Records: Observational Study

Background

With the rapid development of online health communities, increasing numbers of patients and families are seeking health information on the internet.

Objective

This study aimed to discuss how to fully reveal the health information needs expressed by patients with hypertension in their questions in a web-based environment and how to use the internet to help patients with hypertension receive personalized health education.

Methods

This study randomly selected 1000 text records from the question data of patients with hypertension from 2008 to 2018 collected from Good Doctor Online and constructed a classification system through literature research and content analysis. This paper identified the background characteristics and questioning intention of each patient with hypertension based on the patient’s question and used co-occurrence network analysis and the k-means clustering method to explore the features of the health information needs of patients with hypertension.

Results

The classification system for the health information needs of patients with hypertension included the following nine dimensions: drugs (355 names), symptoms and signs (395 names), tests and examinations (545 names), demographic data (526 kinds), diseases (80 names), risk factors (37 names), emotions (43 kinds), lifestyles (6 kinds), and questions (49 kinds). There were several characteristics of the explored web-based health information needs of patients with hypertension. First, more than 49% of patients described features, such as drugs, symptoms and signs, tests and examinations, demographic data, and diseases. Second, patients with hypertension were most concerned about treatment (778/1000, 77.80%), followed by diagnosis (323/1000, 32.30%). Third, 65.80% (658/1000) of patients asked physicians several questions at the same time. Moreover, 28.30% (283/1000) of patients were very concerned about how to adjust the medication, and they asked other treatment-related questions at the same time, including drug side effects, whether to take the drugs, how to treat the disease, etc. Furthermore, 17.60% (176/1000) of patients consulted physicians about the causes of clinical findings, including the relationship between the clinical findings and a disease, the treatment of a disease, and medications and examinations. Fourth, by k-means clustering, the questioning intentions of patients with hypertension were classified into the following seven categories: “how to adjust medication,” “what to do,” “how to treat,” “phenomenon explanation,” “test and examination,” “disease diagnosis,” and “disease prognosis.”

Conclusions

In a web-based environment, the health information needs expressed by Chinese patients with hypertension to physicians are common and distinct, that is, patients with different background features ask relatively common questions to physicians. The classification system constructed in this study can provide guidance to health information service providers for the construction of web-based health resources, as well as guidance for patient education, which could help solve the problem of information asymmetry in communication between physicians and patients.