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Journal of the Korean Academy of Family Medicine 1986;7(12):10-21.
Published online December 1, 1986.
고혈압 환자의 치료지속도에 관한 연구 -한 종합병원과 농촌 의원을 비교하여-
문정주 김기순 김종준
전주예수병원 지역사회보건과 전주예수병원 내과
Abstract
The prevalence of hypertension in Korea is 14.0% in men and 9.8% in women, with the total number standing at more than 1.5 million. As there is no program for early detection or continuous care, cerebrovascular disease is the leading cause of death in both rural and urban areas. In order to establish a control program in rural area, an experimental hypertension clinic was started in Kosan, Cholla pukdo, in 1983, to serve as a hypertension control center and as a teaching facility to the community. In order to determine the effectiveness of the clinic and its control system, a comparative study was done, with a hypertension clinic in Jesus hospital as a standard. The study included patient characteristics, medications prescribed, response of blood pressure to treatment, and especially, the compliance to therapy in the two clinics. 110 hypertensives were studied in the Kosan rural clinic, and 189 in the general Hospital. The results are as follows:
1. 62% of the Hospital patients had medical insurance, while only 38% of the rural patients did. The extent of hypertension was milder at the rural clinic, with the diastolic BP of 80% of the rural patients below 105mmHg. In the uristix test, 7% of the urban patients exhibited glucosuria and 8%, proteinuria, while at the rural clinic, only 2% showed glucosuria and none, proteinuria.
2. The initial medication given in the Hospital setting consisted of diuretics only in 36% of the cases, and a combined regimen with other antihypertensives in 52%, whereas diuretics only were used initially in 87% of the patients in the rural clinic.
3. The mean systolic blood pressure of Hospital patients fell from 175.0 mmHg to 147.9 mmHg within 6 months of treatment, while the diastolic blood pressure fell from 110.3 mmHg to 98.3 mmHg. The mean systolic and diastolic BP at the rural clinic fell from 166.6 mmHg and 96.8 mmHg to 142.6 mmHg and 83.6 mmHg respectively.
4. 49% of Hospital patients visited only once and then dropped out, while 22% adhered to treatment for more than 6 months. But the drop-out rate after only one visit was 24% at the rural clinic while 52% of the patients continued treatment for more than 6 months. Thus, the systematic hypertension control program based at the rural clinic triggered better compliance of treatment from hypertensive patients.
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