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  1. Adi Azriff Basri, S.M Abdul Khader, Cherian Johny, Raghuvir Pai B, Mohammed Zuber, Zainuldin Ahmad, et al.
    MyJurnal
    Introduction: In this study, Renal artery (RA) stenosis of Single Stenosed (SS) and Double Stenosed (DS) with the condition of Normal Blood Pressure (NBP) and High Blood Pressure (HBP) were investigated using the aid of Fluid Structure Interaction (FSI) approach. Methods: Numerical analysis of 3D model patient’s specific abdominal aorta with RA stenosis was conducted using FSI solver in software ANSYS 18. Results: The results of velocity profile, pres- sure drop, time average wall shear stress (TAWSS), Oscillatory shear index (OSI) and total deformation of SS and DS with the condition of NBP and HBP were compared in terms of blood flow and structural wall tissue behaviour. The results concluded SS-NBP produced the highest value of velocity profile, TAWSS and OSI parameter compared to the others. Meanwhile, SS-HBP indicates the highest value pressure drop. On the other hand, SS-HBP and DS-HBP have a higher distribution of deformation contour and also maximum VMS compared to SS-NBP and DS-HBP. Conclusion: With the aid of FSI approach, this studied has proven that the existence of SS at RA location has a higher impact on the velocity magnitude, higher pressure drop, higher TAWSS and OSI value compared to the DS case. This is due to a high concentration of pressure acting at the narrow blood vessel of SS compared to DS cases which most of the blood flow will pass to the lower part of abdominal aorta.
    Matched MeSH terms: Hypertension
  2. Newaz MA, Nawal NN
    Clin Exp Hypertens, 1999 Nov;21(8):1297-313.
    PMID: 10574414
    The aim of this study was to determine the effects of gamma tocotrienol on lipid peroxidation and total antioxidant status of spontaneously hypertensive rats (SHR), comparing them with normal Wistar Kyoto (WKY) rats. SHR were divided into three groups and treated with different doses of gamma tocotrienol (gamma1, 15 mg/kg diet; gamma2, 30 mg/kg diet and gamma3, 150 mg/kg diet). Normal WKY and untreated SHR were used as normal (N) and hypertensive control (HC). Blood pressure were recorded every fortnightly for three months. At the end of the trial, animals were killed and measurement of plasma total antioxidant status, plasma superoxide dismutase (SOD) activity and lipid peroxide levels in plasma and blood vessels were carried out following well established methods. Study shows that lipid peroxides were significantly higher in hypertensive plasma and blood vessels compared to that of normal rats (Plasma- N: 0.06+/-0.01, HC: 0.13+/-0.008; p<0.001, B1. Vessels - N: 0.47+/-0.17, HC: 0.96+/-0.37; p<0.001). SOD activity was significantly lower in hypertensive than normal rats (N = 148.58+/-29.56 U/ml, HC = 110.08+/-14.36 U/ml; p = 0.014). After three months of antioxidant trial with gamma-tocotrienol, it was found that all the treated groups have reduced plasma lipid peroxides concentration but was only significant for group gamma1 (gamma1: 0.109+/-0.026, HC: 0.132+/-0.008; p = 0.034). On the other hand, lipid peroxides in blood vessels reduced significantly in all treated groups (gamma1; p<0.05, gamma2; p<0.001, gamma3; p<0.005). All the three treated groups showed improve total antioxidant status (p<0.001) significantly. SOD activity also showed significant improvement in all groups (gamma1: p<0.001, gamma2: p<0.05, gamma3: p<0.001). Correlation studies showed that, total antioxidant status (TAS) and SOD were significantly negatively correlated with blood pressure in normal rats (p = 0.007; p = 0.008) but not in SHR control. This correlation regained in all three groups SHR's after treatment with tocotrienol. Lipid peroxides in blood vessel and plasma showed a positive correlation with blood pressure in normal and SHR control. This correlation also remains in treated groups significantly except that in gamma3 where positive correlation with plasma lipid peroxide was not significant. In conclusion it was found that antioxidant supplement of gamma-tocotrienol may prevent development of increased blood pressure, reduce lipid peroxides in plasma and blood vessels and enhanced total antioxidant status including SOD activity.
    Matched MeSH terms: Hypertension/blood; Hypertension/physiopathology; Hypertension/prevention & control*
  3. Wong CK, Jaafar MJ
    Turk J Emerg Med, 2021 02 12;21(2):86-89.
    PMID: 33969246 DOI: 10.4103/2452-2473.309138
    BRASH syndrome is a syndrome characterized by bradycardia, renal failure, usage of atrioventricular (AV) nodal blocker, shock, and hyperkalemia (BRASH). It is more common among patients with multiple comorbidities such as cardiac disease, kidney dysfunction, and hypertension requiring AV nodal blockers. Cardiac conduction abnormalities are frequently caused by severe hyperkalemia. However, it may also occur in mild-to-moderate hyperkalemia with concomitant use of AV nodal blockers due to the synergistic effects between these two factors in the presence of renal insufficiency. It is essential for the physician to identify BRASH syndrome as the treatment may differ from standard advanced cardiovascular life support (ACLS) protocol. We report the two cases of patient who presented with BRASH syndrome who failed to respond to standard ACLS protocol.
    Matched MeSH terms: Hypertension
  4. Suzana S, Azlinda A, Hin SL, Khor WH, Zahara Z, Sa'ida MJ, et al.
    Malays J Nutr, 2011 Aug;17(2):163-73.
    PMID: 22303571 MyJurnal
    INTRODUCTION: In Malaysia, hypertension prevalence has increased from 13% in 1996 to 43% in 2006 based on the Third National Health and Morbidity Survey.
    METHODOLOGY: Recognising the importance of hypertension control to prevent cardiovascular morbidity and mortality, a cross-sectional study was carried out to assess factors influencing blood pressure among 74 hypertensive adults (22 men, 52 women, mean age 61.1 +/- 8.8 years old) attending an outpatient clinic of a government health clinic in Klang Valley. Subjects were interviewed to obtain information on social and health, physical activity level and food intake using Diet History Questionnaire (DHQ) and Food Frequency Questionnaire (FFQ). Anthropometric measurements including weight, height, waist circumference and percentage of body fat were also conducted.
    RESULTS: The majority of the subjects (71.6%) had poor hypertension control as determined using blood pressure. Women aged 30-59 years old had a higher mean diastolic blood pressure (87.3 +/- 11.6 mmHg) than women aged 60 years old (78.5 +/- 9.5 mmHg) (p < 0.05). Most of the men (36.4%) achieved three out of six Medical Nutrition Therapy (MNT) for Hypertension Recommendations as outlined by the Malaysian Dietitians' Association. About one-third (30.8%) of the women achieved two out of six of the guidelines. High sodium intake (adjusted OR 3.501, 95% CI 1.116-10.985, p < 0.05), daily consumption of coffee (adjusted OR 0.302, 95% CI 0.093-0.983, p < 0.05) and less intake of milk (adjusted OR 3.328, 95% CI 1.055-10.493, p < 0.05) were associated with uncontrolled hypertension.
    CONCLUSION: Three quarters of the subjects had unsatisfactory hypertensive control and was related to food intake and eating habits including high salt diet, coffee consumption and inadequate milk intake were unsatisfactory. There is a need to implement a nutrition intervention programme based on MNT to achieve good hypertensive control among subjects.
    Study site: klinik kesihatan, Klang Valley, Malaysia
    Matched MeSH terms: Hypertension/etiology; Hypertension/epidemiology*; Hypertension/prevention & control*
  5. Ng TK, Tee ES, Rosman A
    Malays J Nutr, 1995 Sep;1(2):129-39.
    PMID: 22692058 MyJurnal
    This paper highlights the marked presence of nutritional disorders in a sample (190 males, 237 females, aged 18-80 years) obtained from the adult population in three kampungs i.e. Pasang Api, Sungai Nipah Baroh and Sungai Balai Darat, in the Mukim of Bagan Datoh, Perak in 1992. All subjects (except pregnant females) were measured for blood pressure, weight, height, waist circumference, and hip circumference from which the body mass index (BMI) and waist-hip ratios (WHR) were calculated. A random blood sample was obtained by finger-prick from each subject and analysed for total cholesterol (TC) and glucose, using the Reflotron compact analyser. Elevated means for BMI and WHR indicated that obesity (BMI ≥30.0) was a serious public health problem in these three kampungs, affecting about 5% of males and 14% of females. Another 24% of males and 46% of females had an overweight problem (BMI 25.0-29.9), indicating that on the average, about half the adult population in these kampungs were either overweight or obese. This contrasted with the situation a decade ago in similar-type kampungs in the Peninsula where underweight was the major nutritional disorder in adults, especially males. Overall, there was a shift of an underweight problem to one of overweight, as exemplified by increments of 2.0 to 3.0 BMI units in the adult population, with the phenomenon being more marked in the females. Hypertension (21%) and hyperglycaemia (6.5%) affected the males and females approximately equally. Female adults had higher mean plasma TC compared to males (204 versus 199 mg/dl); these means were some 20 mg/dl (0.52 mmol/L) higher than the corresponding means for adults in similar rural communitites in the early eighties, and approximate the corresponding means for present-day urban adults. The above findings serve to emphasise the nutritional transition undergoing in the rural communities in the Peninsula, viz, the marked emergence in these rural communities of nutritional disorders normally associated with affluent populations.
    Matched MeSH terms: Hypertension
  6. Razali N, Agarwal R, Agarwal P, Kumar S, Tripathy M, Vasudevan S, et al.
    Clin Exp Ophthalmol, 2015 Jan-Feb;43(1):54-66.
    PMID: 24995479 DOI: 10.1111/ceo.12375
    BACKGROUND: Steroid-induced ocular hypertension is currently treated in the same way as primary open-angle glaucoma. However, the treatment is often suboptimal and is associated with adverse effects. We evaluated the oculohypotensive effects of topical trans-resveratrol in rats with steroid-induced ocular hypertension and involvement of adenosine receptors (AR) in intraocular pressure (IOP) lowering effect of trans-resveratrol.
    METHODS: The oculohypotensive effect of unilateral single-drop application of various concentrations of trans-resveratrol was first studied in oculonormotensive rats. Concentration with maximum effect was similarly studied in rats with steroid-induced ocular hypertension. Involvement of AR was studied by observing the alterations of IOP in response to trans-resveratrol after pretreating animals with AR subtype-specific antagonists. Additionally, we used computational methods, including 3D modelling, 3D structure generation and protein-ligand interaction, to determine the AR-trans-resveratrol interaction.
    RESULTS: All concentrations of trans-resveratrol produced significant IOP reduction in normotensive rat eyes. Maximum mean IOP reduction of 15.1% was achieved with trans-resveratrol 0.2%. In oculohypertensive rats, trans-resveratrol 0.2% produced peak IOP reduction of 25.2%. Pretreatment with A₁ antagonist abolished the oculohypotensive effect of trans-resveratrol. Pretreatment with A₃ and A₂A AR antagonists produced significant IOP reduction in both treated and control eyes, which was further augmented by trans-resveratrol application in treated eyes. Computational studies showed that trans-resveratrol has highest affinity for A₂B and A₁, followed by A2A and A₃ AR.
    CONCLUSION: Topically applied trans-resveratrol reduces IOP in rats with steroid-induced ocular hypertension. Trans-resveratrol-induced oculohypotension involves its agonistic activity at the A₁ AR.
    KEYWORDS: adenosine receptors; docking simulation; intraocular pressure; resveratrol; topical
    Matched MeSH terms: Ocular Hypertension/chemically induced; Ocular Hypertension/drug therapy*; Ocular Hypertension/metabolism
  7. Sharanjeet-Kaur, Arifah Nur Yahya, Che Muhaya Mohamad, McCarty, C.A.
    MyJurnal
    The purpose of this study was to identify the most common forms of age-related cataracts and to estimate possible risk factors for age-related cataracts in a sample of cataract patients at the National University of Malaysia Hospital. Thirty five patients (17 males and 18 female) with cataracts were recruited from the ophthalmology ward and clinic at the hospital. The age range of the patients was between 39 to 93 years (mean 64.9 11.5 years). The Lens Opacities Classification System (Locs) III was used to grade nuclear, cortical and posterior subcapsular lens opacities. Grading of the cataract was carried out and the following information was collected: initial visual acuity and best-corrected visual acuity, demographic details, health history, dietary intake of antioxidants and lifetime ocular ultraviolet B exposure. Analyses were conducted using a standard case-control design. T-tests were used to assess the significance of continuous variables and chi-squared tests were used for categorical variables. The overall prevalence of cortical cataract was 34.4% (12 patients), nuclear cataract was 60.0% (21 patients), and posterior subcapsular cataract was 57.1% (20 patients). No significant potential risk factor was found for nuclear cataracts. In the case of posterior subcapsular cataract, hypertension was the only potential significant risk factor (x2 = 4.38, p = 0.036), and in the case of cortical cataract, cigarette smoking was the only significant risk factor. Although lifetime effective ocular UV-B exposure was found to be not a significant potential risk factor, but it was seen that for cortical cataracts, the mean difference of lifetime effective ocular UV-B exposure between those with cortical and those without cortical cataracts was larger compared to others with nuclear and posterior subcapsular cataracts. Hypertension was found to be a potential significant risk factor for posterior subcapsular cataract whereas cigarette smoking was a potentially significant risk factor for cortical cataract. Although not statistically significant, lifetime effective ocular UV-B exposure maybe a potential risk factor for cortical cataract.
    Matched MeSH terms: Hypertension
  8. Mohamad Isa, M.F., Tan, C.L., Gill, J.S.
    MyJurnal
    About 60% of people with mental illness developed co-morbid medical and physical illness that invariably worsens their lives. However, most of the studies regarding this issue were done either in the out-patient or community settings, ignoring long stay inpatients. Locally, no data exists among long stay patients in psychiatric institutions. The aim of this retrospective study was to look at the prevalence of physical illness among long-stay patients and to compare the occurrence of physical illness before and after admission to the psychiatric institution. We found that 85 (63.4%) out of 134 subjects there was suffering with co-morbid physical and medical illnesses. There were 33 (24.6%) subjects with hyperlipidaemia, 22 (16.4%) subjects with hypertension and 17 (12.7%) subjects with diabetes. Approximately 75 (55.9%) subjects developed medical illness after admission. In conclusion, long-stay psychiatric patients are at a high risk of developing medical problems that tends to begin after admission to the psychiatric institution.
    Study site: Hospital Bahagia, Ulu Kinta, Perak, Malaysia
    Matched MeSH terms: Hypertension
  9. Wan Nor Arifin, Wan Arfah Nadiah, Muhammad Irfan, Chen, Xin Wee, Nani Draman, Nyi, Nyi Naing
    MyJurnal
    To ensure the reliability of manual blood pressure (BP) readings in a clinical trial, sources of error due to measurement must be reduced as much as possible. Apart from following standard procedure for BP measurement and ensuring good equipments, the measurement errors that come from the assessors themselves should be assessed. Objective: To demonstrate the use of two-way random effects, interactions absent, absolute agreement (Type A), single measures (Type 1) intraclass correlation coefficient (ICC) in the assessment of reliability of manual BP readings among assessors involved in a clinical trial using manual BP measurement, by using an interrater reliability study conducted by the authors as an example study. Methods: The steps involved in obtaining ICC in the study were discussed. Sample size given the number of assessors in the study was calculated. BP was measured using regularly maintained mercury sphygnomanometers, following recommendations by Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) for BP measurement in office setting. The outcomes were systolic and diastolic BP readings. A type of ICC, two-way random effects, interactions absent, absolute agreement (Type A), single measures (Type 1) ICC was chosen for the analysis and specifically discussed. Pre-requisite assumptions for ICC were meticulously checked and described. The interrater reliability for systolic and diastolic BP readings as expressed by ICC (single measure) were presented with confidence interval (CI). The ICCs obtained in the example study were discussed and concluded. The flaws of the study were also criticised. Results: The interrater reliability for systolic and diastolic BP measurements as expressed by ICC (single measure) were 0.87 (95% confidence interval [CI] 0.722, 0.956) and 0.77 (95% CI 0.560, 0.918) respectively. Conclusion: We demonstrated the steps required to obtain ICC. Since the use of manual BP measurement using mercury sphygmomanometer is still considered as gold standard of BP measurement, it is important that studies in which the BP outcome is measured using such method conduct interrater reliability studies properly.
    Matched MeSH terms: Hypertension
  10. Siti Norsuryani Shamsuddin, Azelinda Ahmad, Haslina Taib, Wan Majdiah Wan Mohamad
    MyJurnal
    Chronic periodontitis (CP) is an inflammatory disease of the supporting tissues of the teeth caused by specific microorganism. Hypertension is one of the major causes of cardiovascular disease whereas periodontitis has recently drawn increasing attention because of its potential relationship with cardiovascular disease. The objectives of this study were to determine the prevalence of the hypertension in CP patients as well as to evaluate the association between hypertension and severity of CP. One hundred and eighty five records of CP patients treated in Dental Clinic, Universiti Sains Malaysia Hospital (USM Hospital), Kelantan from 2010 until 2013 were retrieved and reviewed. The diagnosis of periodontal disease and the presence of hypertension were recorded. The severity of chronic periodontitis was classified into mild, moderate and severe according to the clinical attachment loss. The data was obtained and analyzed using SPSS version 20.0. Majority of the subjects were from Malay ethnic group (94.4%) at the age range between 41 and 61 years (67.8%). In conclusion, the prevalence of hypertension in chronic periodontitis patients was 12.2%. There was no significant association between hypertension and severity of CP (p=0.229).
    Matched MeSH terms: Hypertension
  11. Jefferelli Shamsul Bahrin, Hanifah Bujang, Nizam Jemoin
    MyJurnal
    There is a high prevalence of chronic diseases in the community. Promoting health at the workplace is an effective measure to manage such diseases. This study shares the findings of country-wide company health screening program. The prevalence of high cholesterol among participants was 29 %, high blood pressure was 8% and high blood sugar was 3%. The prevalence of high cholesterol from workplace screening was higher than the community prevalence but the prevalence of high blood pressure and high blood sugar was lower than the community prevalence. The various factors influencing these findings are discussed.
    Matched MeSH terms: Hypertension
  12. Ahmed Dahiru Balami, Musa Mohammed Baba
    MyJurnal
    Hypertension is a condition associated with adverse vascular complications. Its
    prevalence is on the increase globally and same is true for Nigeria. Very few studies
    have assessed the prevalence, awareness, treatment and blood pressure control
    among hypertensive patients in Nigeria. The few available studies generally show
    figures less than 50% for all the three indicators of success with regards to
    hypertension. These studies are however deficient in their coverage, country
    representativeness and methodology, and as such, they fail to provide the evidence
    for which conclusions can be drawn. There is need to intensify blood pressure
    screening at both hospital and community levels. More comprehensive research with
    wider coverage and sound methodologies are also needed to determine those
    associated factors and to discover better treatment options for hypertension in
    Nigeria. These findings would guide health promotion activities and policy making.
    Matched MeSH terms: Hypertension
  13. Siti Radziah Shaik Alaudeen, Aszrin Abdullah, Azarisman Shah Mohd Shah, Norlelawati Abdul Talib
    MyJurnal
    Copy number variation (CNV) caused by changes in DNA sequences of 1000
    or more bases is implicated with susceptibility to common diseases. A study on CNV
    esv27061 among hypertensive Australian adults reported association with high blood
    pressure (BP). In Malaysia, no study on CNV among hypertensive young adults is
    available. Thus, this investigation aimed to assess the CNV esv27061 of young Malaysian
    adults with high blood pressure using optimized ddPCR. (Copied from article).
    Matched MeSH terms: Hypertension
  14. Al-Ahmad BEM, Kashmoola MA, Mustafa NS, Hassan H, Arzmi MH
    Eur J Dent, 2018 4 17;12(1):120-122.
    PMID: 29657536 DOI: 10.4103/ejd.ejd_322_17
    Objective: This study aimed to investigate the relationship between tooth loss and the level of blood pressure with the hypothesis that tooth loss is associated with the increase of hypertension in postmenopausal women.

    Materials and Methods: Sixty postmenopausal female patients aged 51-68 years were included in the study to assess the relationship between tooth loss and the level of blood pressure. The information including sociodemographics, last menstruation period, hypertension history, and the duration of having tooth loss was recorded. Blood pressure was measured using sphygmomanometer and the number of tooth loss was determined.

    Results: The results showed a more significant tooth loss in hypertension (median: 23 + 4; interquartile range [IQR]: 6) compared to the normotension postmenopausal women (median: 18 + 6; IQR: 12; P < 0.05). Furthermore, obese patients had more tooth loss (median: 23 + 5; IQR: 8) than the overweight patients (median: 19 + 8; IQR: 8).

    Conclusion: Tooth loss is associated with the increase of hypertension in postmenopausal women which may have a role in the development of vascular diseases.

    Matched MeSH terms: Hypertension
  15. Sunggip C, Nishimura A, Shimoda K, Numaga-Tomita T, Tsuda M, Nishida M
    Pharmacol Res, 2017 Jun;120:51-59.
    PMID: 28336370 DOI: 10.1016/j.phrs.2017.03.013
    Aging has a remarkable effect on cardiovascular homeostasis and it is known as the major non-modifiable risk factor in the development of hypertension. Medications targeting sympathetic nerve system and/or renin-angiotensin-aldosterone system are widely accepted as a powerful therapeutic strategy to improve hypertension, although the control rates remain unsatisfactory especially in the elder patients with hypertension. Purinergic receptors, activated by adenine, uridine nucleotides and nucleotide sugars, play pivotal roles in many biological processes, including platelet aggregation, neurotransmission and hormone release, and regulation of cardiovascular contractility. Since clopidogrel, a selective inhibitor of G protein-coupled purinergic P2Y12 receptor (P2Y12R), achieved clinical success as an anti-platelet drug, P2YRs has been attracted more attention as new therapeutic targets of cardiovascular diseases. We have revealed that UDP-responsive P2Y6R promoted angiotensin type 1 receptor (AT1R)-stimulated vascular remodeling in mice, in an age-dependent manner. Moreover, the age-related formation of heterodimer between AT1R and P2Y6R was disrupted by MRS2578, a P2Y6R-selective inhibitor. These findings suggest that P2Y6R is a therapeutic target to prevent age-related hypertension.
    Matched MeSH terms: Hypertension/drug therapy*; Hypertension/etiology; Hypertension/metabolism
  16. Chew KT, Ahmad MF, Yong SL, Mohamed Ismail NA
    J Obstet Gynaecol, 2017 Jul;37(5):677-678.
    PMID: 28350528 DOI: 10.1080/01443615.2017.1284774
    Matched MeSH terms: Hypertension, Pulmonary
  17. Manju K
    Family Physician, 1994;6:6-8.
    Hypertensive disorders of pregnancy is a major cause of fetal and maternal morbidity. Epidemiologic observations have shown an inverse association between calcium intake and incidence of eclampsia. Calcium supplementation has been reported to decrease blood pressure in pregnant women, although this remains controversial. The mechanism responsible for the effect of calcium on hypertinsion in pregnant women is unknown. This paper is a review of some of the recent calcium supplementation trials that have been carried out and their effectiveness in reducing systolic and diastolic blood pressure and decreasing the incidence of hypertensive disorders of pregnancy.
    Matched MeSH terms: Hypertension
  18. Zack R, Okunade O, Olson E, Salt M, Amodeo C, Anchala R, et al.
    Hypertension, 2019 05;73(5):990-997.
    PMID: 30929516 DOI: 10.1161/HYPERTENSIONAHA.118.11916
    High blood pressure is the leading modifiable risk factor for mortality, accounting for nearly 1 in 5 deaths worldwide and 1 in 11 in low-income countries. Hypertension control remains a challenge, especially in low-resource settings. One approach to improvement is the prioritization of patient-centered care. However, consensus on the outcomes that matter most to patients is lacking. We aimed to define a standard set of patient-centered outcomes for evaluating hypertension management in low- and middle-income countries. The International Consortium for Health Outcomes Measurement convened a Working Group of 18 experts and patients representing 15 countries. We used a modified Delphi process to reach consensus on a set of outcomes, case-mix variables, and a timeline to guide data collection. Literature reviews, patient interviews, a patient validation survey, and an open review by hypertension experts informed the set. The set contains 18 clinical and patient-reported outcomes that reflect patient priorities and evidence-based hypertension management and case-mix variables to allow comparisons between providers. The domains included are hypertension control, cardiovascular complications, health-related quality of life, financial burden of care, medication burden, satisfaction with care, health literacy, and health behaviors. We present a core list of outcomes for evaluating hypertension care. They account for the unique challenges healthcare providers and patients face in low- and middle-income countries, yet are relevant to all settings. We believe that it is a vital step toward international benchmarking in hypertension care and, ultimately, value-based hypertension management.
    Matched MeSH terms: Hypertension/economics; Hypertension/epidemiology; Hypertension/therapy*
  19. Aziz F, Malek S, Mhd Ali A, Wong MS, Mosleh M, Milow P
    PeerJ, 2020;8:e8286.
    PMID: 32206445 DOI: 10.7717/peerj.8286
    Background: This study assesses the feasibility of using machine learning methods such as Random Forests (RF), Artificial Neural Networks (ANN), Support Vector Regression (SVR) and Self-Organizing Feature Maps (SOM) to identify and determine factors associated with hypertensive patients' adherence levels. Hypertension is the medical term for systolic and diastolic blood pressure higher than 140/90 mmHg. A conventional medication adherence scale was used to identify patients' adherence to their prescribed medication. Using machine learning applications to predict precise numeric adherence scores in hypertensive patients has not yet been reported in the literature.

    Methods: Data from 160 hypertensive patients from a tertiary hospital in Kuala Lumpur, Malaysia, were used in this study. Variables were ranked based on their significance to adherence levels using the RF variable importance method. The backward elimination method was then performed using RF to obtain the variables significantly associated with the patients' adherence levels. RF, SVR and ANN models were developed to predict adherence using the identified significant variables. Visualizations of the relationships between hypertensive patients' adherence levels and variables were generated using SOM.

    Result: Machine learning models constructed using the selected variables reported RMSE values of 1.42 for ANN, 1.53 for RF, and 1.55 for SVR. The accuracy of the dichotomised scores, calculated based on a percentage of correctly identified adherence values, was used as an additional model performance measure, resulting in accuracies of 65% (ANN), 78% (RF) and 79% (SVR), respectively. The Wilcoxon signed ranked test reported that there was no significant difference between the predictions of the machine learning models and the actual scores. The significant variables identified from the RF variable importance method were educational level, marital status, General Overuse, monthly income, and Specific Concern.

    Conclusion: This study suggests an effective alternative to conventional methods in identifying the key variables to understand hypertensive patients' adherence levels. This can be used as a tool to educate patients on the importance of medication in managing hypertension.

    Matched MeSH terms: Hypertension
  20. Chua SS, Lee YK, Chua CT, Abdullah MS
    JUMMEC, 2002;7:100-106.
    Many studies have shown that failure in the control of hypertension with oral antihypertensives could be associated with noncompliance. The present study was conducted to assess the compliance rate to antihypertensive therapies and also to determine factors related to any noncompliance. The study was conducted in a teaching hospital in Kuala Lumpur. Data was collected from patients' medical records and via personal interview using a structured questionnaire. Out of a total of 175 respondents recruited in the study, 49.1% missed at least a dose of their antihypertensive agents during a one·month period. The most common reason given by respondents who were not compliant to their antihypertensive therapies was forgetfulness (91.8%), followed by too busy (20.0%) and insufficient medication supplied to them (18.8%). None of the factors analysed, including the demography of the respondents, their knowledge about hypertension and the types of antihypertensive therapies they were on, had any statistically significant influence on the compliance behaviour of the respondents to their antihypertensive therapies. However, more than 80% of the respondents kept their appointment to see their doctor and only this factor appeared to be related to the medication compliance behaviour although it still did not reach any statistical significance. KEYWORDS: Compliance, antihypertensive agent, blood pressure, knowledge
    Matched MeSH terms: Hypertension
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