Management of Arterial Hypertension: 2018 ACC/AHA Versus ESC Guidelines and Perioperative Implications

Travieso-González, Alejandro; Núñez‐Gil, Iván J.; Říha, Hynek; Donaire, José Antonio García; Ramakrishna, Harish

doi:10.1053/j.jvca.2019.03.068

“…In recent years, the management of HR in patients with hypertension has been increasingly concerned. Hypertension management guidelines in Europe, Taiwan, and other regions all point out the importance of RHR management for hypertensive patients [ 5 , 6 ]. Therefore, HR management has become a new direction of comprehensive management of hypertensive patients following the control of BP, blood sugar, and blood lipids.…”

Section: Introductionmentioning

confidence: 99%

Application Effect of Doctor-Nurse-Patient Integration Model Based on Heart Rate Management Strategies in Middle-Aged and Young Outpatients with Hypertension

Zhang

¹

,

Han

²

,

Jiang

³

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. In this study, a doctor-nurse-patient integration management scheme based on heart rate (HR) management strategies was constructed to explore its application effect in the health management of young and middle-aged outpatients with hypertension. Methods. A total of 75 young and middle-aged patients with essential hypertension admitted to the Outpatient Department of Cardiology of Heji Hospital Affiliated to Changzhi Medical College, Shanxi Province, from October 2019 to July 2020 were selected and divided into an observation group ( n = 37 ) and a control group ( n = 38 ) according to different treatment methods. The control group was treated with routine health education, basis on which, the observation group was additionally intervened by the doctor-nurse-patient integration model established upon HR management strategies. The resting heart rate (RHR) awareness, medication compliance, RHR, systolic/diastolic blood pressure (SBP/DBP), and self-management ability were compared between the two groups before and 3 months after intervention. The diet control rate, hypertension awareness rate, and regular review rate were also compared. Results. The RHR awareness and medication compliance were significantly higher in the observation group compared with the control group after intervention ( P < 0.05 ). There were 29 patients with high compliance in the observation group and 19 in the control group, with a significant difference between the two groups ( P < 0.05 ). The mean RHR, as well as the mean SBP and DBP in the observation group, were significantly lower than those in the control group ( P < 0.05 ). In terms of health behavior assessment, the observation group outperformed the control group in the score of each dimension of self-actualization, health responsibility, stress management, interpersonal support, exercise, and nutrition ( P < 0.05 ). In addition, the self-management ability of diet, exercise, medication, blood pressure (BP) monitoring, and disease awareness was significantly higher in the observation group compared with the control group. Conclusions. For middle-aged and young outpatients with hypertension, the doctor-nurse-patient integration model based on HR management strategies can improve the RHR awareness of patients and improve their medication compliance and self-management ability, thus better controlling the levels of RHR and BP.

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“…One of the primary considerations and exclusions among these causes is inadequate depth of anesthesia and analgesia. Additionally, factors such as laryngoscopy, endotracheal intubation and extubation procedures, surgical stimuli, hypoxia, hypercarbia, hypervolemia, bladder distension, and increased intracranial pressure can contribute to intraoperative hypertension 12 . Another significant factor is the failure of patients with known hypertension to take their routine antihypertensive medications during the preoperative period.…”

Section: Discussionmentioning

confidence: 99%

Acute and Resistant İntraoperative Hypertension during Mitral Valve Replacement: A Case Presentation

Sert,

Yargı,

Özdemir

et al. 2024

MRAJ

0

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Background: Intraoperative hypertension continues to be a significant cause of morbidity and mortality for patients undergoing surgery. In this case presentation, an instance of sudden, unexpected, and resistant hypertension during surgery will be discussed in a patient who underwent mitral valve replacement. Case report: A 75-year-old patient with known coronary artery disease and advanced mitral stenosis underwent mitral valve replacement surgery. During the intraoperative process, after the completion of cannulation procedures and transitioning to partial bypass, a sudden increase in blood pressure was observed in the patient. Blood pressure was only brought under control through the intravenous administration of a triple antihypertensive agent. Upon postoperative evaluation following a smooth completion of the surgery and discharge, findings suggested that the cause of the hypertension in the patient might be renovascular hypertension. Conclusions: Intraoperative hypertension, when unexpected and sudden, can lead to an increase in mortality and morbidity. During the intraoperative process, efforts should be made to identify the underlying causes promptly, and appropriate interventions should be carried out. In the postoperative period, patients should be thoroughly evaluated for underlying reasons.

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“…Surgical management is an administrative work with comprehensiveness and multidisciplinary coordination, especially for critically ill patients such as acute cerebral infarction. The scientific and modern perioperative management can be realized only via setting up the reasonable organizational structure and optimizing the management process constantly [ 19 – 21 ]. With the development of medical information technology, information means provide the possibility for the realization of meticulous surgical management.…”

Section: Discussionmentioning

confidence: 99%

Effect of Standardized Perioperative Management on EEG Indexes and Nerve and Limb Functions of Patients with Acute Cerebral Infarction Undergoing Mechanical Thrombectomy

Gong¹,

Wang

²

2022

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Objective. To explore the application value of standardized perioperative management in mechanical thrombectomy for acute cerebral infarction. Methods. 98 patients with acute cerebral infarction admitted to our hospital from January 2019 to January 2022 were selected as the study sample in this study, and all patients were given the standardized perioperative management. According to the interventional methods, they were divided into the thrombolytic treatment group (arteriovenous combined thrombolysis, n = 49 ) and mechanical thrombectomy group (mechanical thrombectomy, n = 49 ) to compare the nerve function, limb function, thrombolysis in myocardial infarction (TIMI) flow grade, symptomatic intracranial hemorrhage within 24 hours, acute vascular reocclusion, and the death status within 1 year and incidence of adverse events in 90 days of the two groups after treatment. Results. After treatment, the values of brain symmetry index (BSI) and power ratio indices (DTABR) in the two groups were obviously lower than those before treatment ( P < 0.05 ), and the values of BSI and DTABR in the mechanical thrombectomy group were lower than those in the thrombolytic treatment group ( P < 0.05 ). According to the statistical data of National Institutes of Health Stroke Scale (NIHSS) score in patients, the NIHSS scores of the two groups after treatment were visibly decreased ( P < 0.05 ), while the NIHSS score in the mechanical thrombectomy group after treatment was lower than that in the thrombolytic treatment group ( P < 0.05 ). The proportion of modified Rankin scale (mRS) score < 3 in the mechanical thrombectomy group was distinctly higher than that in the thrombolytic treatment group ( P < 0.05 ). The proportion of TIMI flow grade ≥ 2 in the mechanical thrombectomy group was significantly higher than that in the thrombolytic treatment group ( P < 0.05 ). The rate of symptomatic intracranial hemorrhage within 24 hours in the mechanical thrombectomy group was lower than that in the thrombolytic treatment group ( P < 0.05 ), with the indistinctive difference between the two groups ( P > 0.05 ). The incidence of acute vascular reocclusion in the mechanical thrombectomy group was markedly lower than that in the thrombolytic treatment group ( P < 0.05 ). There was no significant difference in 1-year mortality between the two groups ( P > 0.05 ). In the mechanical thrombectomy group, there were 1 case of gingiva bleeding, 1 case of hemorrhinia, and 2 cases of recurrent cerebral infarction in 90 days, with a total of 4 cases (8.16%), while in the thrombolytic treatment group, there were 4 cases of gingiva bleeding, 4 cases of hemorrhinia, and 15 cases of recurrent cerebral infarction in 90 days, with a total of 23 cases (46.94%), indicating that the incidence of adverse events in 90 days in the mechanical thrombectomy group was significantly lower than that in the thrombolytic treatment group ( P < 0.05 ). Conclusion. The standardized perioperative management is effective in patients with acute cerebral infarction who were treated with arteriovenous combined thrombolysis or mechanical thrombectomy, which can improve the neurological function and physical function of patients. However, the mechanical thrombectomy has a better improvement effect on the neurological function and physical function of patients, with the relatively better safety, thrombolytic effect, and long-term prognosis.

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Management of Arterial Hypertension: 2018 ACC/AHA Versus ESC Guidelines and Perioperative Implications

Cited by 16 publications

References 20 publications

Application Effect of Doctor-Nurse-Patient Integration Model Based on Heart Rate Management Strategies in Middle-Aged and Young Outpatients with Hypertension

Application Effect of Doctor-Nurse-Patient Integration Model Based on Heart Rate Management Strategies in Middle-Aged and Young Outpatients with Hypertension

Acute and Resistant İntraoperative Hypertension during Mitral Valve Replacement: A Case Presentation

Effect of Standardized Perioperative Management on EEG Indexes and Nerve and Limb Functions of Patients with Acute Cerebral Infarction Undergoing Mechanical Thrombectomy

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