Health beliefs, compliance - hypertension
Article Abstract:
Hypertension, a major risk factor for cardiovascular disease and stroke, is usually controllable by medication. The prevalence of hypertension has been very high among blacks, but seems to be declining. However, hypertension-related mortality is still a problem among younger black people. Poor compliance (failure to take medication as prescribed) is thought to be the major reason for poor hypertension control in black and white patients. To improve treatment, the factors influencing compliance were studied in a group of 54 hypertensive black women, aged 45 to 70, who were treated at a public clinic in New Orleans. One group of 22 women believed that hypertension is a biomedical disease; only 6 of these women (27 percent) complied poorly with treatment. The 32 women in the second group believed that high blood pressure is two diseases, specifically ''high blood'' and ''high-pertension''. High blood was considered to be a condition involving hot or thick blood that was controllable by diet or folk remedies. On the other hand, high-pertension was regarded as a nerve disease related to emotional excitement. Twenty of the women in the second group (63 percent) complied poorly with prescribed treatment. These results demonstrate that physicians must be familiar with patients' knowledge and beliefs in order to improve patient education and treat hypertension effectively. To meet the public health goal of decreasing hypertension and related diseases, this study indicates that it is important to spend time with each patient. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1990
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The uncertainties surrounding carotid endarterectomy
Article Abstract:
Carotid endarterectomy may be an effective method for preventing strokes in patients with severe carotid artery disease, or narrowing of the opening of the carotid artery. The procedure involves the removal of the diseased lining and fatty deposits from the interior of the carotid artery. Three research studies found that carotid endarterectomy may be more effective than non-surgical treatments for preventing strokes in patients with carotid artery disease. Post-operative complications and complications associated with pre-operative arteriography, or imaging of the carotid artery, may not outweigh the benefits of carotid endarterectomy. Ultrasound and other non-invasive imaging techniques may be safer than arteriography, but they may not be as effective. Carotid endarterectomy may be recommended for patients on the basis of the severity of the narrowing of the carotid artery and factors increasing the risk of complications.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
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