No abstract

Background:For the effective management of hypertension, drug adherence and life style modification are important. We investigated the effects of mobile phone text-message reminders on compliance and life style modification in patients with hypertension. Methods: The study was performed at family medicine outpatient clinics at 15 hospitals in South Korea from July 2008 to June 2010. Study subjects included 1,449 patients who were all prescribed candesartan cilexetil. Patients were randomly divided into two groups-mobile phone text-message reminder group and control group. In the reminder group, contents of text messages were recommendations for antihypertensive adherence, exercise, low salt diet, and reduction of weight and alcohol. In the control group, the date of next visit was sent at 10 week. Mobile phone text-messages were sent at 2, 4, 6, 8 and 10 weeks by the coordinating center. Thereafter, they were followed up for 12 weeks. Chi-square test was performed to compare compliance and performance indexes of the two groups. Results: The reminder group had 719 (49.6%) patients vs. 730 (50.4%) patients in the control group. Attendance rate were 92.8% for the reminder group and 94.7% for the control group (P=0.14). 94.7% of the reminder group and 94.0% of the control group took their medication regularly (P=0.59). The target blood pressure was attained in 75.8% of the reminder group and 75.4% of the control group (P=0.87). Similarly, rates of weight loss, decreased alcohol use, increased physical activity and a low salt diet showed no significant differences between the two groups. Conclusions: In our study, mobile phone text reminders did not show to have any significant positive effect on the management of hypertension.

Background: Moyamoya vessels, an abnormal vascular collateral network at the base of the brain, are associated with moyamoya disease and secondary moyamoya syndrome. Several studies have suggested that ischemic symptoms in patients with moyamoya vessels are most closely related to hemodynamic impairment. However, few studies have evaluated cerebral perfusion state in secondary atherosclerotic moyamoya syndrome. The purpose of our study was to evaluate cerebral hemodynamics measured by acetazolamide CT perfusion (CTP) imaging in patients with moyamoya syndrome associated with symptomatic atherosclerotic occlusion of the unilateral middle cerebral artery (MCA). Methods: Multidetector helical CTP imaging was performed in 14 patients (mean age, 54.4 years), who were clinically diagnosed to have moyamoya syndrome associated with unilateral atherosclerotic steno-occlusion of the proximal MCA. All patient underwent cerebral angiography and CTP imaging. Hemodynamic quantitative parameters of regional cerebral blood flow (rCBF), cerebral blood volume (rCBV), and mean transit time (rMTT) were measured in the anterior cerebral artery (ACA), MCA, and posterior cerebral artery (PCA) territories of both hemispheres separately. The Cerebral vascular reserve (CVR) capacity was measured using acetazolamide. Results: Mean resting rCBF in the ipsilesional ACA and MCA territories were significantly lower than in the contralateral territories (P<0.05). After acetazolamide infusion, the rCBF was significantly increased in the ipsilesional ACA, PCA, and all three contralateral territories (P<0.05) and rCBV was significantly increased in the all ipsilesional and contralateral territories (P<0.05). The CVR capacity changes were not significantly different between ipsilesional and contralateral territories. Conclusions: These findings suggest that the affected MCA territory has decreased perfusion with poor vasomotor reactivity despite abundant collateral circulation through the basal moyamoya vessels in patients with atherosclerotic moyamoya syndrome.