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Hypertensive patients: Evaluation of a therapeutic education program
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Topic 6 - Hypertension
Conclusion Our results suggest that the prevalence of MetS is dramatically increased among hypertensive women and this prevalence is not influenced by age. Interventions should be planned to increase the awareness of cardiologists to diagnose and treat the MetS. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.02.049 198
Hypertensive patients: Evaluation of a therapeutic education program M. Mouadili ∗ , C. Mbauchy , D. Benzaroual , S. Elkarimi , M. Elhattaoui Cardiologie et maladies vasculaires, Centre hospitalier universitaire Mohammed VI Marrakech, Marrakech, Maroc ∗ Corresponding author. E-mail address: [email protected] (M. Mouadili) Objective Evaluation of a therapeutic education program for hypertensive patients over a 6-month period with personalized objectives. Patients and methods A prospective single-center study conducted in 106 patients, the study was conducted as follows: — an initial collection of epidemiological, clinical and paraclinical data from patients in normal consultation; — each patient received a therapeutic education session personalized- with education in the use of the ‘‘hypertension follow-up notebooks’’ developed by the work team (Fig. 1); — the monitoring of the effectiveness of the education program was carried out over three evaluation consultations over the 6 months of the survey. Results One hundred and six patients participated in the study: mean age 47 ± 10 years; 62.26% of them were male (66 patients). Essential hypertension in 95.28% of patients, grade II to III, uncontrolled in approximately 70% of them. With an average evolution period of 9.5 ± 7.5 years. At 6 months, a significant decrease of SAP (from 154 ± 3 to 143 ± 3 mmHg, P less than 0.01) and DAP (from 95 ± 2 to 87 ± 2 mmHg, P less than 0.01) was notified. 50.7% versus 33.8% of patients have SAP and DAP in the therapeutic objectives. The monitoring of dietary and physical activity objectives is correlated with the decrease in BP (P < 0.05). A significant increase in self-monitoring with therapeutic decision-making (P < 0.01). A significant decrease in hypertension-related distress and feelings of failure (P < 0.01). Success rate among patients who chose the objective ‘‘reduce salt’’: 53%, ‘‘reduce fat’’: 50%, ‘‘walk several times/week (30 min)’’: 88%, ‘‘exercise at least once/week’’: 22%. 67% have at least one physical activity objective in place. No significant decrease in weight (−0.6 ± 4.1 kg) but 39% lost at least 2 kg. Conclusion A therapeutic education program with personalized objectives can give significant results at 6 months in terms of BP figures, dietetics and physical activity, self-monitoring of hypertension while reducing feelings of distress.
Fig. 1 Booklet of information and monitoring of hypertensive patients.
Disclosure of interest peting interest
The authors declare that they have no com-
https://doi.org/10.1016/j.acvdsp.2019.02.050 406
Specific treatment of pulmonary artery hypertension in Eisenmenger patients: About 4 cases H. Adnane ∗ , A. Eladaoui , O. Naour , A. Drighil , R. Habbal Cardiologie, CHU Ibn Rochd Casablanca, Casablanca, Maroc ∗ Corresponding author. E-mail address: [email protected] (H. Adnane) Introduction Eisenmenger’s syndrome is defined by the appearance of cyanosis during the evolution of left-right shunts, due to a progressive alteration of the pulmonary arteriolar bed, leading to an increase in pulmonary vascular resistance. This evolution of the shunt towards a reaction of Eisenmenger, makes that its simple surgical closure becomes useless. The only surgical treatment is pulmonary transplantation, or cardiopulmonary transplantation. The interest of specific medical treatment of pulmonary arterial hypertension in Eisenmenger Syndrome remains controversial. Objective Evaluate the impact of the specific treatment of PAH on Eisenmenger patients. Methods We report the evolution over 1 year of 4 patients with congenital heart diseases in Eisenmenger. For each patient we evaluated NYHA functional class, 6 MWT, echocardiographic and hemodynamic parameters. Results Two of our patients had atrioventricular canal defect: — one complete; — the other partial; 2 patients with patent arterial duct. These patients were put under specific treatment of PAH: sildenafil + macitentan. Clinically, there was a slight improvement in the dyspnoea stage from stage III to II, with an average of 6MWT at 287 m. On the echocardiographic plan Peak tricuspid regurgitation velocity which averaged 4.59 m/s decreased to 3.5 m/s after one year of treatment with PASP by tricuspid regurgitation on average at 93 mmHg at the beginning of the treatment then at 70 mmHg at 1 year. Humodynamically, the PAPm (mmHg) were at 38 before specific treatment and decreased to 32 at the end of treatment, with a cardiac output that went from 2.3 to 2.5 l/min/m2 , and an RVP of 7 to 5 wood units. We did not notice any complications and no deaths were reported.
Topic 6 - Hypertension
Conclusion Our results suggest that the prevalence of MetS is dramatically increased among hypertensive women and this prevalence is not influenced by age. Interventions should be planned to increase the awareness of cardiologists to diagnose and treat the MetS. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.02.049 198
Hypertensive patients: Evaluation of a therapeutic education program M. Mouadili ∗ , C. Mbauchy , D. Benzaroual , S. Elkarimi , M. Elhattaoui Cardiologie et maladies vasculaires, Centre hospitalier universitaire Mohammed VI Marrakech, Marrakech, Maroc ∗ Corresponding author. E-mail address: [email protected] (M. Mouadili) Objective Evaluation of a therapeutic education program for hypertensive patients over a 6-month period with personalized objectives. Patients and methods A prospective single-center study conducted in 106 patients, the study was conducted as follows: — an initial collection of epidemiological, clinical and paraclinical data from patients in normal consultation; — each patient received a therapeutic education session personalized- with education in the use of the ‘‘hypertension follow-up notebooks’’ developed by the work team (Fig. 1); — the monitoring of the effectiveness of the education program was carried out over three evaluation consultations over the 6 months of the survey. Results One hundred and six patients participated in the study: mean age 47 ± 10 years; 62.26% of them were male (66 patients). Essential hypertension in 95.28% of patients, grade II to III, uncontrolled in approximately 70% of them. With an average evolution period of 9.5 ± 7.5 years. At 6 months, a significant decrease of SAP (from 154 ± 3 to 143 ± 3 mmHg, P less than 0.01) and DAP (from 95 ± 2 to 87 ± 2 mmHg, P less than 0.01) was notified. 50.7% versus 33.8% of patients have SAP and DAP in the therapeutic objectives. The monitoring of dietary and physical activity objectives is correlated with the decrease in BP (P < 0.05). A significant increase in self-monitoring with therapeutic decision-making (P < 0.01). A significant decrease in hypertension-related distress and feelings of failure (P < 0.01). Success rate among patients who chose the objective ‘‘reduce salt’’: 53%, ‘‘reduce fat’’: 50%, ‘‘walk several times/week (30 min)’’: 88%, ‘‘exercise at least once/week’’: 22%. 67% have at least one physical activity objective in place. No significant decrease in weight (−0.6 ± 4.1 kg) but 39% lost at least 2 kg. Conclusion A therapeutic education program with personalized objectives can give significant results at 6 months in terms of BP figures, dietetics and physical activity, self-monitoring of hypertension while reducing feelings of distress.
Fig. 1 Booklet of information and monitoring of hypertensive patients.
Disclosure of interest peting interest
The authors declare that they have no com-
https://doi.org/10.1016/j.acvdsp.2019.02.050 406
Specific treatment of pulmonary artery hypertension in Eisenmenger patients: About 4 cases H. Adnane ∗ , A. Eladaoui , O. Naour , A. Drighil , R. Habbal Cardiologie, CHU Ibn Rochd Casablanca, Casablanca, Maroc ∗ Corresponding author. E-mail address: [email protected] (H. Adnane) Introduction Eisenmenger’s syndrome is defined by the appearance of cyanosis during the evolution of left-right shunts, due to a progressive alteration of the pulmonary arteriolar bed, leading to an increase in pulmonary vascular resistance. This evolution of the shunt towards a reaction of Eisenmenger, makes that its simple surgical closure becomes useless. The only surgical treatment is pulmonary transplantation, or cardiopulmonary transplantation. The interest of specific medical treatment of pulmonary arterial hypertension in Eisenmenger Syndrome remains controversial. Objective Evaluate the impact of the specific treatment of PAH on Eisenmenger patients. Methods We report the evolution over 1 year of 4 patients with congenital heart diseases in Eisenmenger. For each patient we evaluated NYHA functional class, 6 MWT, echocardiographic and hemodynamic parameters. Results Two of our patients had atrioventricular canal defect: — one complete; — the other partial; 2 patients with patent arterial duct. These patients were put under specific treatment of PAH: sildenafil + macitentan. Clinically, there was a slight improvement in the dyspnoea stage from stage III to II, with an average of 6MWT at 287 m. On the echocardiographic plan Peak tricuspid regurgitation velocity which averaged 4.59 m/s decreased to 3.5 m/s after one year of treatment with PASP by tricuspid regurgitation on average at 93 mmHg at the beginning of the treatment then at 70 mmHg at 1 year. Humodynamically, the PAPm (mmHg) were at 38 before specific treatment and decreased to 32 at the end of treatment, with a cardiac output that went from 2.3 to 2.5 l/min/m2 , and an RVP of 7 to 5 wood units. We did not notice any complications and no deaths were reported.