Male sexual behavior influences the rates of cervical dysplasia and invasive cervical cancer, as well as male human papillomavirus (HPV) infection and disease. Unfortunately, little is known regarding male HPV type distribution by age and across countries. In samples combined from the coronal sulcus, glans penis, shaft, and scrotum of 1,160 men from Brazil, Mexico, and the United States, overall HPV prevalence was 65.2%, with 12.0% oncogenic types only, 20.7% nononcogenic types only, 17.8% both oncogenic and nononcogenic, and 14.7% unclassified infections. Multiple HPV types were detected in 25.7% of study participants. HPV prevalence was higher in Brazil (72.3%) than in the United States (61.3%) and Mexico (61.9%). HPV16 (6.5%), HPV51 (5.3%), and HPV59 (5.3%) were the most commonly detected oncogenic infections, and HPV84 (7.7%), HPV62 (7.3%), and HPV6 (6.6%) were the most commonly detected nononcogenic infections. Overall HPV prevalence was not associated with age. However, significant associations with age were observed when specific categories of HPV, nononcogenic, and unclassified HPV infections were considered. Studies of HPV type distribution among a broad age range of men from multiple countries is needed to fill the information gap internationally with respect to our knowledge of HPV infection in men.

To understand hypertensive patients' perspectives regarding blood pressure and hypertension treatment, this qualitative study applied semistructured interviews of hypertensive patients. Participants were recruited from two hypertension clinics at the University of Alberta in Edmonton, Canada. To be eligible for inclusion, patients had to be aged 18 years or older, diagnosed with hypertension by a healthcare provider, and currently taking an antihypertensive medication. Participants were stratified in the analysis according to blood pressure control. Twenty-six patients (mean age 57; 62% female) were interviewed, of which 42% were on target and 58% were not. Three underlying themes emerged from the interviews: (a) knowledge of blood pressure relating to diagnosis and management and control of hypertension, (b) integration of hypertension management into daily routine, and (c) feelings and beliefs of wellness. None of the above themes were associated with better control. Knowledge gaps were found, which emphasize the need for further patient education and physician training. Feelings and beliefs of wellness, and not knowledge, were important factors in home assessment of blood pressure. The absence of connections between control of hypertension and the identified domains indicates that current approaches could benefit from the development of a more personalized approach for education and communication.

Effective communication is a prerequisite for any successful encounter between patient and provider. Nevertheless, it is unclear how/where communication can impact/affect adherence to antihypertensive medication, and maintenance of lifestyle changes to control blood pressure targets. Poor physician communication is correlated with a higher risk of treatment nonadherence. Given the high rates of hypertension globally, this review serves to enlighten aspects of the communication exchange from a provider, context, and patient perspective. Relevant articles were analyzed to assess barriers, solutions, and optimizations for communication with hypertensive patients. To support the findings, a model of communication in the context of hypertension treatment is presented, which comprises three phases: comprehension and acceptance, translation into action, and long-term retention. Secondly, an analysis of care providers (bedside manner, verbal/nonverbal communication, empathy and sex, time, knowledge base), context (format and tailoring of the message, and physical environment), and patient-related factors (sex, socio-economic status, language and health literacy, culture, age, psychological factors) were assessed in relation to hypertension. Current literature is limited regarding reciprocal communication, adaptive packaging of messages, and active verification of effective communication. To improve communication, hypertension care programs could benefit from better communication training, more team-based approaches, and flexible tools based on information technology.

Abstracts e139 tools provided. The guideline pays special attention to CVR reduction, foot care, renal assessment, and screen of all Ͼ 45 years of age and obese for CMR.Objectives To investigate perioperative blood pressure (BP) changes in the outpatients with cataract surgery.Design and Methods Forty-one outpatients (mean age 71.2 Ϯ 7.2 years) who visited an ophthalmologic clinic for cataract surgery were enrolled. Sitting BP was measured at the clinic visit before surgery (Clinic BP). On the day of surgery, BP was measured 1 hour before surgery (Pre BP). During the surgery, BP was measured every 5 minutes. Clinic BP and Pre BP were averaged and defi ned as baseline BP. First 3 BP measurements during surgery were averaged and defi ned as operative BP. Max BP was the maximum BP values during surgery. Characteristics, pharmacological records and blood chemistry of the patients were collected. The predictive ability of baseline BP for excessive operative BP elevation was evaluated using receiver-operated characteristic analysis.Results Twenty-eight patients (63.6 %) were treated with antihypertensive drugs (HT group). The average changes from baseline to operative BP were ϩ 13.9 Ϯ 13.9/8.4 Ϯ 8.7 mmHg (baseline BP:134.7 Ϯ 13.9/74.4 Ϯ 10.6 vs operative BP: 148.6 Ϯ 22.6/82.9 Ϯ 10.9, P Ͻ 0.05). Max BP was 152.8 Ϯ 23.4/83.5 Ϯ 11.5 mmHg. In 8 patients (18.2 %), systolic BP (SBP) reached 170 mmHg (excessive riser). Operative and Max SBP were significantly correlated with baseline SBP (operative BP: r ϭ 0.67, P Ͻ 0.01, Max BP: r ϭ 0.70, P Ͻ 0.01) but not with age. The magnitude of the changes of SBP was not associated with baseline SBP. Max SBP in HT were significantly higher than non-HT (159.0 Ϯ 18.0 vs143.3 Ϯ 3.3, P Ͻ 0.01). In the subgroup of excessive riser, baseline SBP and increment SBP were signifi cantly greater (151.1 Ϯ 13.0 vs130.7 Ϯ 14.9, P Ͻ 0.01 and ϩ 24.2 Ϯ 19.0 vs ϩ 11.4 Ϯ 15.1, P Ͻ 0.05, respectively) . Multiple regression analyses indicated that Max SBP was signifi cantly associated with baseline SBP (ß1.05, P Ͻ 0.01) . Pre SBP predicted excessive riser more accurately than Clinic SBP and the cut off values of that at maximum sensitivity (75.0 %) and specifi city (78.8 %) was 144 mmHg. Design and MethodsAfter consent, renal patients with self-reported hypertension (n ϭ 35) used a tablet to complete a pre-questionnaire assessing knowledge of salt, read through an online educational tool, and completed a post-questionnaire. Recommended daily sodium intake and consequences linked to high salt intake were the most improved items. After 2 weeks, patients repeated the questionnaire at home. ResultsBefore the educational tool, patients answered 3 to 9(m ϭ 7) of the questions correctly. Immediately following the tool, this number had increased to 6 to 10 (m ϭ 9) (P Ͻ 0.01). It took 20-25 minutes to complete the questionnaires and the tool. After 2 weeks, some, but not all of the knowledge was retained (6 to 10 (m ϭ 8). Satisfaction with the online educational tool was reported by 97% of patients, and 86% found the...

Abstracts e139 tools provided. The guideline pays special attention to CVR reduction, foot care, renal assessment, and screen of all Ͼ 45 years of age and obese for CMR.Objectives To investigate perioperative blood pressure (BP) changes in the outpatients with cataract surgery.Design and Methods Forty-one outpatients (mean age 71.2 Ϯ 7.2 years) who visited an ophthalmologic clinic for cataract surgery were enrolled. Sitting BP was measured at the clinic visit before surgery (Clinic BP). On the day of surgery, BP was measured 1 hour before surgery (Pre BP). During the surgery, BP was measured every 5 minutes. Clinic BP and Pre BP were averaged and defi ned as baseline BP. First 3 BP measurements during surgery were averaged and defi ned as operative BP. Max BP was the maximum BP values during surgery. Characteristics, pharmacological records and blood chemistry of the patients were collected. The predictive ability of baseline BP for excessive operative BP elevation was evaluated using receiver-operated characteristic analysis.Results Twenty-eight patients (63.6 %) were treated with antihypertensive drugs (HT group). The average changes from baseline to operative BP were ϩ 13.9 Ϯ 13.9/8.4 Ϯ 8.7 mmHg (baseline BP:134.7 Ϯ 13.9/74.4 Ϯ 10.6 vs operative BP: 148.6 Ϯ 22.6/82.9 Ϯ 10.9, P Ͻ 0.05). Max BP was 152.8 Ϯ 23.4/83.5 Ϯ 11.5 mmHg. In 8 patients (18.2 %), systolic BP (SBP) reached 170 mmHg (excessive riser). Operative and Max SBP were significantly correlated with baseline SBP (operative BP: r ϭ 0.67, P Ͻ 0.01, Max BP: r ϭ 0.70, P Ͻ 0.01) but not with age. The magnitude of the changes of SBP was not associated with baseline SBP. Max SBP in HT were significantly higher than non-HT (159.0 Ϯ 18.0 vs143.3 Ϯ 3.3, P Ͻ 0.01). In the subgroup of excessive riser, baseline SBP and increment SBP were signifi cantly greater (151.1 Ϯ 13.0 vs130.7 Ϯ 14.9, P Ͻ 0.01 and ϩ 24.2 Ϯ 19.0 vs ϩ 11.4 Ϯ 15.1, P Ͻ 0.05, respectively) . Multiple regression analyses indicated that Max SBP was signifi cantly associated with baseline SBP (ß1.05, P Ͻ 0.01) . Pre SBP predicted excessive riser more accurately than Clinic SBP and the cut off values of that at maximum sensitivity (75.0 %) and specifi city (78.8 %) was 144 mmHg.Conclusions Baseline SBP can predict excessive SBP elevation during surgery. Patients whose preoperative SBP are more than 145 mmHg needs careful monitoring of BP during surgery and appropriate medication may be considered to prevent perioperative cardiovascular event. CILNIDIPINE SHORTENS QT INTERVAL IN HYPERTENSIVE PATIENTSBackground The prolongation of cardiac repolarization time and morning sympathetic overactivity coexist in hypertensives with morning BP surge. Cilnidipine ameliorates the ventricular electrical remodeling in the hypertrophied heart which causes the QT prolongation using the heart of the canine model of chronic atrioventricular block.Purpose To determine whether cilnidipine improves ventricular repolarization delay in the hypertensive heart.Methods 52 outpatients prescribed cilnidipine (10mg/day) were ret...