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首页> 外文期刊>Journal of human hypertension >Difficult-to-control hypertension: identification of clinical predictors and use of ICT-based integrated care to facilitate blood pressure control
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Difficult-to-control hypertension: identification of clinical predictors and use of ICT-based integrated care to facilitate blood pressure control

机译：难以控制的高血压：识别临床预测器和使用ICT的综合护理，促进血压控制

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摘要

Difficult-to-control (DTC) hypertension represents a burden in real life that can be partially solved through identification of the characteristics of clinical patterns and tailoring antihypertensive strategies, including ICT-enabled integrated care (ICT-IC). In the quest for clinical predictors of DTC hypertension, we screened 482 hypertensive patients who were consecutively referred to the departmental hypertension clinic. Following a data quality check, patients were divided into controlled (C, 49.37%) and uncontrolled (UC, 50.63%) groups based on their systolic blood pressure (BP) at follow-up. We then performed statistical analysis on the demographic, clinical, laboratory, and ultrasound data and observed that older age, female sex, higher BP levels, and a family history of hypertension were predictors of DTC hypertension. We then developed a pilot service of ICT-IC, including weekly home visits by nurses and patient education on self-monitoring of BP, heart rate, body weight, and oxygen saturation using 3G-connected devices. Self-monitored data were transmitted to the hospital servers on the electronic chart of the patient for remote assessment by the hospital hypertension specialists. A total of 20 UC patients (M/F = 10/10; age: 72.04 +/- 2.17 years) were enrolled to verify the efficacy of BP control without changes in medical treatment. After 1 month of the ICT-IC program, BP was reduced both at the office assessment (systolic BP (SBP): 162.40 +/- 2.23 mm Hg, beginning of the program vs. 138.20 +/- 4.26 mm Hg at 1 month, p 0.01) and at home (SBP: 149.83 +/- 3.44, beginning of the program vs. 134.16 +/- 1.67 mm Hg at 1 month, p 0.01). We concluded that DTC hypertension can be predicted based on the clinical characteristics at the first visit. For these patients, ICT-IC is a feasible therapeutic strategy to achieve BP control.
机译：难以控制的（DTC）高血压代表现实生活中的负担，可以通过鉴定临床模式的特征和剪裁抗高血压策略，包括启用ICT的综合护理（ICT-IC）。在寻求DTC高血压的临床预测因子中，我们筛选了482名高血压患者，该患者连续提及培养课程高血压诊所。在数据质量检查之后，患者基于随访时的收缩压（BP）分为受控（C，49.37％）和不受控制的（UC，50.6％）组。然后，我们对人口统计学，临床，实验室和超声数据进行了统计分析，观察到年龄较大的年龄，女性性别，更高的BP水平以及高血压的家族史是DTC高血压的预测因子。然后，我们开发了ICT-IC的试点服务，包括护士和患者教育的每周家庭访问BP，心率，体重和使用3G连接装置的氧饱和度。将自我监控数据传输到医院服务器上，以患者的电子图表，用于医院高血压专家的远程评估。共有20例UC患者（M / F = 10/10;年龄：72.04 +/- 2.17岁），以验证BP控制的疗效而不改变医疗。在1个月的ICT-IC计划之后，在办公室评估（SYSTOLIC BP（SBP）：162.40 +/- 2.23 mm HG，程序开始，138.20 +/- 4.26 mm Hg，1个月， P＆ 0.01）和在家（SBP：149.83 +/- 3.44，程序开始与134.16 +/- 1.67 mm hg，p <0.01）。我们得出结论，DTC高血压可以根据第一次访问的临床特征来预测。对于这些患者，ICT-IC是实现BP控制的可行的治疗策略。

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