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Biomedical subjects

J E Carnahan

Publications and source records attributed to J E Carnahan.

4 recordsLinked to original sources

Salt restriction in hypertensive patients. Comparison of advice, education, and group management.

The purpose of this study was to identify the best of three methods of treating hypertensive outpatients in order to minimize dietary sodium levels and thereby decrease the need for antihypertensive drugs. Forty-eight outpatients with hypertension were randomly assigned to three treatment programs: (1) advice; (2) an intensive educational program; and (3) small-group management plus feedback. This last program had a problem-solving format in which patients shared ideas and provided mutual support for dietary change. Only these group management patients were told the results of their sodium determinations. In a one-year study, group management plus the feedback to patients of information on the sodium content of their urine was more effective in decreasing dietary sodium intake than advice or an intensive educational effort.

Adult↗

Increasing compliance. Patient-operated hypertension groups.

Compliance was compared in 52 previously noncompliant hypertensive patients randomly assigned for eight weeks to either a nurse-operated hypertension clinic (control) or a patient-operated hypertension group] (experimental). Control patients listened to audiotapes on hypertension and its management and met individually with a nurse who adjusted their drug regimens. Experimental patients were trained to take their own blood pressure (BP) and select their own drugs in a group program emphasizing informed self-help. After the eight-week training period and at two- and six-month follow-up visits, both groups had significantly lower BPs. Compared with control patients, experimental patients had lower diastolic BPs, better pill counts, and better attendance (all P < .05). This study suggests that training noncompliant patients in groups to manage their own hypertension may achieve better results than traditional management programs.

Female↗

The effects of self-monitoring by patients on the control of hypertension.

The effects of self-monitoring of blood pressure on the control of hypertension were examined in this study. Failure of patients to comply with treatment is presumably attributable in part to the fact that hypertension usually is asymptomatic until complications develop. Self-monitoring might make visible an otherwise asymptomatic condition, and thereby increase motivation. One hundred hypertensive patients beginning outpatient treatment were randomly assigned to experimental and control groups. Subjects were given a sphygmomanometer and instructed in its use. Both groups were given similar antihypertensive medications. After six months of treatment, mean systolic pressure was significantly lower (11.4 mm Hg, p smaller than 0.05) in the experimental than in the control subjects. However, the mean baseline systolic pressure in the control group was 3.9 mm Hg less than that of the experimental group. If this value is substracted from the difference between the last mean systolic pressures in the two groups, the 7.5 mm Hg difference is seen as a very modest effect of self-monitoring. Diastolic blood pressure was insignificantly lower for experimental subjects. Compared to the potent effectiveness of drugs in reducing blood pressure, self-monitoring was of little value.

Antihypertensive Agents↗