×
Home Current Archive Editorial board
News Contact
Review paper

Identification of conditions which lead to unjustified requests for emergency treatment of hypertensive patients

By
Suad Sivić Orcid logo ,
Suad Sivić
Contact Suad Sivić

Department of Social Medicine, Institute for Health and Food Safety Zenica, Zenica, Bosnia and Herzegovina

Larisa Gavran ,
Larisa Gavran

Family Medicine Teaching Centre, Health Care Centre Zenica, Zenica, Bosnia and Herzegovina

Salih Tandir ,
Salih Tandir

School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

Elvir Peštalić
Elvir Peštalić

Department for Quality of Health Care, Primary Health Care Gradačac, Gradačac, Bosnia and Herzegovina

Abstract

Aim
To determine most common factors making patients with high blood pressure seek professionally unacceptable treatment of hypertension at the Emergency Department.
Methods
The survey was conducted at the Emergency Department of the Primary Health Care in Gradačac on randomly selected 207 patients who requested medical help because of high blood pressure. For all patients arterial blood pressure and body mass index (BMI) were measured. A survey about knowledge and attitudes regarding habits that affect high blood pressure as well as the socioeconomic conditions was made.
Results
Prevalence of 10.3% was found with regard to visits to emergency care by patients due to high blood pressure. Most patients, 127(61.4 %), were overweight and 36(17.4%) were obese. Patients who rarely controlled their blood pressure were more frequent visitors of emergency medical services. Stressful situation occurs as a factor in a variety of forms. The survey showed that 76 (36.7%) patients sought medical help even though they had no blood pressure values that required emergency care.
Conclusion
Poorly organized health care system with no continuous and comprehensive preventive promotional programs caused by inappropriate use of resources in health care. The reorganization of primary care with full implementation of family medicine and greater integration of family medicine with other levels of the health care system should provide a better control and treatment of other diseases such as hypertension.

References

1.
Bloch M. Worldwide prevalence of hypertension exceeds 1.3 billion. J Am Soc Hypertens. 2016. p. 753–4.
2.
Kapadia S. Trends in cardiovascular risk profiles. Cleve Clin J Med. 2017. p. 6-e9.
3.
Institute of Medicine (US) Committee on Social Security Cardiovascular Disability Criteria. Cardiovascular Disability: Updating the Social Security Listings. National Academies Press;
4.
Monahan M, Jowett S, Lovibond K, Gill P, Godwin M, Greenfield S, et al. PROOF-BP investigators. Predicting out-of-office blood pressure in the clinic for the diagnosis of hypertension in primary care: an economic evaluation. Hypertension. 2018. p. 250–61.
5.
Rudnick K, Sackett D, Hirst S, Holmes C. Hypertension: The family physician’s role. Can Fam Physician. 1978. p. 477–84.
6.
Gascón J, Sánchez-Ortuño M, Llor B, Skidmore D, Saturno P. Why hypertensive patients do not comply with the treatment: results from a qualitative study. Fam Pract. 2004. p. 125–30.
7.
Carter B, Bosworth H, Green B. The hypertension team: the role of the pharmacist, nurse, and teamwork in hypertension therapy. J Clin Hypertens (Greenwich). 2012. p. 51–65.
8.
Khan N, Bacon S, Khan S, Perlmutter S, Gerlinsky C, Dermer M, et al. Hypertension management research priorities from patients, caregivers, and healthcare providers: A report from the Hypertension Canada Priority Setting Partnership Group. J Clin Hypertens (Greenwich). 2017. p. 1063–9.
9.
Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. Europ Heart J. 2013. p. 2159–219.
10.
Arbe G, Pastor I, Franco J. Diagnostic and therapeutic approach to the hypertensive crisis. Med Clin (Barc). 2017. p. 30822–9.
11.
Dimković S, Obrenović K. Hipertenzivna kriza. Med Glas. 2007. p. 36–46.
12.
Janke A, Mcnaughton C, Brody A, Welch R, Levy P. Trends in the Incidence of hypertensive emergencies in US emergency departments from 2006 to 2013. JAm Heart Assoc. 2016. p. 4511.
13.
Erdine S, Redon J, Böhm M, Ferri C, Kolloch R, Kreutz R, et al. Are physicians underestimating the challenges of hypertension management? Results from the Supporting Hypertension Awareness and Research Europe-wide (SHARE) survey. Eur J Prev Cardiol. 2013. p. 786–92.
14.
Franklin S, Thijs L, Li Y, Li, Hansen W, Boggia J, et al. International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO) Investigators. Masked hypertension in diabetes mellitus: treatment implications for clinical practice. Hypertension. 2013. p. 964–71.
15.
Salkic S, Ljuca F, Batic-Mujanovic O, Brkic S, Dz M, Mustafic S. The frequency of hypertension crises in the. Emergency Medical Service Department in Tuzla. Med Arch. 2013. p. 393–6.
16.
Salkic S, Brkic S, Batic-Mujanovic O, Ljuca F, Karabasic A, Mustafic S. Emergency room treatment of hypertensive crises. Med Arch. 2015. p. 302–6.
17.
Pickering D, Stevens S. How to measure and record blood pressure. Community Eye Health. 2013. p. 76.
18.
Klabunde R. Cardiovascular Physiology Concepts. Lippincott Williams & Wilkins; 2012.
19.
Physical Status: the Use and Interpretation of Anthropometry. Geneva: WHO. 1995.
20.
Juraschek S, Woodward M, Sacks F, Carey V, Miller E, Appel L. Time course of change in blood pressure from sodium reduction and the DASH diet. Hypertension. 2017. p. 923–9.
21.
Park C, Fang J, Hawkins N, Wang G. Comorbidity status and annual total medical expenditures in U.S. hypertensive adults. Am J Prev Med. 2017. p. 172–81.
22.
Grotto I, Huerta M, Sharabi Y. Hypertension and socioeconomic status. Curr Opin Cardiol. 2008. p. 335–9.
23.
Kitaoka M, Mitoma J, Asakura H, Anyenda O, Nguyen T, Hamagishi T, et al. The relationship between hypertension and health-related quality of life: adjusted by chronic pain, chronic diseases, and life habits in the general middle-aged population in Japan. Environ Health Prev Med. 2016. p. 193–214.
24.
Najafipour H, Nasri H, Afshari M, Moazenzadeh M, Shokoohi M, Foroud A, et al. Hypertension: diagnosis, control status and its predictors in general population aged between 15 and 75 years: a community-based study in southeastern Iran. Int J Public Health. 2014. p. 999–1009.
25.
Byrd J, Brook R. Anxiety in the "age of hypertension. Curr Hypertens Rep. 2014. p. 486.
26.
Kulkarni S, Farrell O, Erasi I, Kochar M, M. Stress and hypertension. WMJ. 1998. p. 34–8.
27.
Šimunović V. Health care in Bosnia and Herzegovina before, during, and after 1992-1995 war: a personal testimony. Confl Health. 2007. p. 7.
28.
Krousel-Wood M, Muntner P, Anderson C, Delaune A, Cushman E, Cutler W, et al. Hypertension control among newly treated patients before and after publication of the main ALLHAT results and JNC 7 guidelines. J Clin Hypertens (Greenwich). 2012. p. 277–83.
29.
Black H, Elliott W, Neaton J, Grandits G, Grambsch P, Grimm R, et al. Anders RJ. Baseline characteristics and early blood pressure control in the CONVINCE Trial. Hypertension. 2001. p. 12–8.

Citation

Authors retain copyright. This work is licensed under a Creative Commons Attribution 4.0 International License. Creative Commons License

 

Article metrics

Google scholar: See link

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.