Archives of Cardiovascular Diseases Supplements (2016) 8, 244-246
0330 Factors associated with medication non-adherence in hypertensive patients Ahmed Chetoui, Khadija Mzoughi *, Ihsen Zairi, Emna Ben Gaied Hassine, Hayfa Ben Daamar, Mohamed Baccouche, Fethia Ben Moussa, Sana Fennira, Sofien Kamoun, Sondos Kraiem Hôpital Habib Thameur, Tunis, Tunisie * Corresponding author: [email protected]
(Khadija Mzoughi) Introduction In a recent study, only 24% of hypertensive patients reached blood pressure goal in Tunisia. One of the major problems is the adherence to long-term therapy for chronic illnesses in developed countries. Aim To evaluate drug compliance and to identify factors associated with non-adherence to antihypertensive medication. Materials and methods Treatment compliance was evaluated by the Girerd questionnaire among hypertensive outpatients seen in the Habib Thameur's Hospital. Results Patients mean age was 65 years-old, 45% were elderly patients and 77 % were women. Fourty-two percent of the patients were illiterate and about a quarter had a poor socioeconomic status. Seventy-seven percent of the patients knew their treatment. Non-adherence to medication was present in 93 % of participants. Among them, three patients had quit their drugs. Medication non-adherence was due to forgetting in 44%, important number of tablets intake (>=5) in 24%, illness deny in 15%, high cost of drugs in 15% and the feeling that the treatment is ineffective treatment in 2%. In univariate analysis, female gender and the important number of tablets intake were significantly associated with medication non-adherence (respectively, p=0,02 and p=0,004). Conclusion The treatment compliance of hypertension patients in our community is not good. Positive activation from interaction of physicians and patients can help enhancing patient's medicine adherence.
Conclusions the 3 measurement strategies provide similar average BP estimates. The ABPM device can be very valuable to rise some ambiguity and can give important prognostic information. The author hereby declares no conflict of interest
0304 Heart rate in dippers and in non-dippers investigated by ambulatory blood pressure monitoring Kaoutar Kharbouche * (1), Fairouz Haloui (2), Rachida Habbal (1) (1) CHU Ibn Rochd, Casablanca, Maroc – (2) CHU Ibn Rochd, Cardiologie, Casablanca, Maroc * Corresponding author: [email protected]
(Kaoutar Kharbouche) Background In normal cases, nocturnal blood pressure (BP) falls between 10–20%, compared with daytime BP (BP dipper pattern).The non-dipping pattern of ambulatory BP is associated with secondary hypertension and target organ damage. Our aim was to investigate the difference of heart rate between non-dippers and dippers. Methods BP variability can be estimated as a standard deviation of ambulatory BP monitoring obtained by every 15–20 min measurement. The ambulatory BP and HR were monitored every 20 min with a fully automatic device. Ambulatory BP monitoring were performed in 124 patients in the University hospital Ibn Rochd in Casablanca. We measured the blood pressure and heart rate parameters. The criteria of non-dipping pattern was diurnal index, 10%. Results Non-dipping pattern was found in 41 cases and dipping pattern was found in 83 cases. The 24h systolic blood pressure in non-dipping group (NDG) was 133.92±16.89 mmHg, in the dipping group (DG) was 127.49±13.81 mmHg (p= 0.005) and the diastolic was 75.38±12.81 mmHg (NDG) and 75.67±11.91 mmHg (DG) (p= 0.08). The heart rate was lower in the NDG than in the DG: 69.65±9.81 vs 70.59±9.48 bpm (p= 0.02). Conclusion In NDG, we found lower heart rate. Presumably reflecting altered function of the sympathetic nervous system, the baroreceptor oscillations are shifted to lower frequencies. It is clear that more work should be carried out to evaluate the impact of heart rate variability on non dipper patients.
The author hereby declares no conflict of interest
The author hereby declares no conflict of interest
Ambulatory blood pressure monitors in our daily practice: why use it more often? Fatimazahra Sabri *, Mariam Abelhad, Rachida Habbal CHU Ibn Rochd, Casablanca, Maroc * Corresponding author: [email protected]
0210 Obstructive sleep apnea syndrome in hypertensive patients
Purpose Discordance between blood pressure (BP) measurement methods can occur and create ambiguity. The automated BP monitors (ABPM) are already available for years, In addition to 24-hour values, the circadian variation of BP adds prognostic significance in predicting cardiovascular outcome. But this devises are no often prescribed in our population. The objective of this study is to quantify concordance among BP measurement methods and to define the diagnostic sensitivity, specificity, and prognostic value of ABPM in a Moroccan population of hypertensive patients. Methods The office mercury sphygmomanometer, the ambulatory BP monitor (ABPM), with an oscillometric device, and home self-measurement with an automatic device were compared in an observational prospective study. 50 patients were enrolled. Ambulatory BP monitoring was performed. A nondipping pattern was defined when nocturnal systolic BP dip was < 10% of daytime systolic BP. Results Average BP results were similar between measurement methods with the exception of daytime ABPM, which was significantly higher: sphygmomanometer, 127.9±12.3/83.9±7.3 mm Hg; 24-hour ABPM, 132.6±10.7/ 84,2±8.7 mm Hg; day ABPM, 136.5±12.5/86.0±11.9 mm Hg; home self-measurement, 131.0±14.3/82.5±8.2 mm Hg. Discordance in the achievement of therapeutic goals was observed in 23 patients, with only 6 cases being explained by masked hypertension or “white coat syndrome” according to all measurements. The prevalence of nondipping was 44%, the nondipping pattern was associated with advanced age, obesity, diabetes, and overt cardiovascular or renal disease.
Dalila El Baghdadi *, Ghita Mouhsine, Safaa Raboukhi, Leila Azzouzi, Rachida Habbal CHU Ibn Rochd, Casablanca, Maroc * Corresponding author: [email protected]
(Dalila El Baghdadi) Background The obstructive sleep apnea syndrome has become a recognized public health problem especially because of its high prevalence and its cardiovascular consequences especially on arteriel hypertension. Aim to assess the relationship between OSA and hypertension. Methods we conducted a prospective comparative study between hypertensive subjects (GSH group) and non hypertensive (GSNH group); OSAS was confirmed by ventilatory polygraphy between January 2013 and July 2014. Results There was 46 hypertensive and 54 non hypertensive patients patients with a clear female predominance in both groups.The metabolic syndrome was found in 61% of cases in the GSH against 16% in the GSNH (p<0,01) .The tobacco consumption and smoking post COPD were more common in the GSNH (p<0.01).Obesity was found respectively in 77% vs 36% of patients (p<0.01 ) .In the 2 groups, there was no difference in clinical expression (epworth average score 15) .According to the score of Berlin, all hypertensive subjects were at high risk of developing OSAS while GSNH were at intermediate risk .The average of apnea-hypopnea index wasa 19 (GSH) vs 16 (GSNH) (p = 0.70) mainly obstructive apnea with an average saturation of 93% .The use of CPAP was necessary in 8 hypertensive patients (22%). The evolution is marked by the stabilization of blood pressure with a decrease in the number of antihypertensive drugs in 75% of cases. Regarding
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