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Analysis of blood pressure measurement in Czech pharmacies I.
Prouza, Jakub ; Malý, Josef (advisor) ; Marešová, Helena (referee)
Analysis of blood pressure measurement in Czech pharmacies I. Author: Jakub Prouza Tutor: Josef Malý1 1 Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Králové Introduction: Arterial hypertension is one of the most serious health problems of today and its therapy must be approached comprehensively. In addition to medical care, to the improvement of the health status of the patient significantly contribute properly implemented pharmaceutical care and blood pressure measurement in pharmacy. Objectives: The aim of the thesis was to describe and analyse conditions of blood pressure measurement in a sample of Czech pharmacies. Methods: Data were collected via questionnaire survey in 2012 and 2013 in three districts. The survey was conducted using two questionnaires, which were filled at pharmacies with possible help of trained interviewer. The first questionnaire was completed by the authorized employee representative of the pharmacy and included questions characterizing the pharmacy. Furthermore the question whether they provided blood pressure measurement in the pharmacy. If they did, further questions were on the frequency of measurement, instrumentation and space equipment in pharmacy. The second questionnaire was completed by the pharmacy...
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Analysis of care in patients at risk for arterial hypertension in pharmacy II.
Panáčková, Kateřina ; Malý, Josef (advisor) ; Marešová, Helena (referee)
Analysis of care in patients at risk for arterial hypertension in pharmacy II. Author: Kateřina Panáčková Tutor: PharmDr. Josef Malý, Ph.D.1 Consultant: PharmDr. Stanislav Havlíček2 1 Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Králové 2 Pharmacy Luna, Plzeň Introduction: Arterial hypertension is one of the most common illnesses in the Czech Republic. Not only this should be the reason for proper health education and early detection of clients endangered by this illness. Objectives: The objective of the thesis was to perform and evaluate consultancy activities in a pharmacy focusing on clients with a risk of arterial hypertension or with already diagnosed arterial hypertension. Methodology: Collection of data took place in a public pharmacy in Česká Lípa between 1 May 2013 and 27 June 2014. Measuring of blood pressure was a part of controlled interview with clients of the pharmacy. Following data was recorded into a form: social-demographic characteristics of the respondend, his/her attitude towards measuring blood pressure in the pharmacy, incidence of risk factors of arterial hypertension, respectively atherosclerosis and other illnesses in the anamnesis, medication including nutrition supplements, results of own measurings and proposed...
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Analysis of care in patients at risk for arterial hypertension in pharmacy IV.
Kotlanová, Lada ; Malý, Josef (advisor) ; Mareček, Aleš (referee)
Analysis of care in patients at risk for arterial hypertension in pharmacy IV. Author: Lada Kotlanová Tutor: PharmDr. Josef Malý, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague Introduction and aim: Arterial hypertension (AH) belongs due to its pressure and atherosclerotic complications among very serious global health problems. The main goal of the therapy of AH is to prevent these complications, comprising early diagnosis and proper treatment plan. The aim of the study was to realize counselling in a pharmacy focused on clients with the risk of AH or already diagnosed AH. Metodology: Data were collected in a community pharmacy in Kralovice from September 2014 to January 2015. Prior to blood pressure measurement, the controlled interview was conducted with each client using special form which enabled to obtain important data from clients' history. Following data were obtained: socio-demographic characteristics of each client; their relationship to blood pressure measurement; risk factors of AH or atherosclerosis, respectively; disease history and use of drugs including food supplements. Results of blood pressure measurement, proposed intervention, or drug related problems were also subsequently recorded into the form thus...
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Aldosterone synthase in arterial hypertension and possible influence of its genenetic polymorphism on left ventricular hypertrophy
Heller, Samuel ; Horký, Karel (advisor) ; Málková, Jana (referee) ; Widimský, Jiří (referee)
Part I. The aldosterone synthase gene (CYP11B2) polymorphism T-344C in blood pressure and left ventricular hypertrophy. BACKGROUND: Aldosterone is a key cardovascular hormone, it significantly influences volume, pressure and electrolyte balance. Aldosterone plays an important role in development of left ventricular (LV) hypertrophy and myocardial fibrosis. The aldosterone synthase gene (CYP11B2) is an important candidate gene region in essential hypertension. DESIGN AND METHODS: We assessed the influence of the T-344C polymorphism of aldosterone synthase - the rate-limiting enzyme in aldosterone biosynthesis - on the structure of the left ventricle in young normotensive men. The population included 113 normotensive mid-European Caucasian men aged 18-40 years (mean 27 +/- 5 years). We also studied the association of -344T/C polymorphism of the CYP11B2 gene with the presence and severity of hypertension in 369 individuals, of whom 213 were hypertensive patients (139 controlled hypertensive, 74 resistant hypertensive) and 156 were healthy normotensive subjects. The genotype was assessed using polymerase chain reaction with subsequent cleavage with restriction enzyme HAEIII (restriction fragment length polymorphism method) and visualization with ethidium bromide. Plasma renin activity (PRA) and plasma...
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Analysis of care in patients at risk for arterial hypertension in pharmacy I.
Gregor, Stanislav ; Malý, Josef (advisor) ; Matoulková, Petra (referee)
Analysis of care in patiens at risk for arterial hypertension in pharmacy I. Author: Stanislav Gregor1 Tutor: Josef Malý1 Consultant: Stanislav Havlíček2 1 Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Králové 2 Czech Chamber of Pharmacists, Prague Introduction: Arterial hypertension represents a serious health problem. Despite of the fact that great attention is paid to an early diagnosis and therapy of arterial hypertension, it remains compensated insufficiently in a number of patients. Objectives: The aim of the thesis was to analyse the possibilities of pharmaceutical care provided to patients who are at risk of arterial hypertension. Methodology: Blood pressure was measured from the beginning of October till December 2012 in a public pharmacy in Moravská Třebová. The blood pressure was measured by a pharmacist by means of a validated and calibrated tonometer. Other data were collected from a directed interview with the pharmacy client. The data were evaluated in Microsoft Excel 2007 and processed by means of the frequency analysis. A retrospective analysis of drug problems was further performed in patients who have been using pharmacotherapy or food supplements. Results: The data were obtained from 196 pharmacy clients (31 % of men and...
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Metabolic and structural differences in primary aldosteronism and essential hypertension
Šomlóová, Zuzana ; Widimský, Jiří (advisor) ; Mlíková Seidlerová, Jitka (referee) ; Červenka, Luděk (referee)
Hypertension is a major risk factor for cardiovascular (CV) disease, and patients with primary aldosteronism (PA) - the most common endocrine cause of hypertension - have a higher incidence of CV complications. The aim of this study was to evaluate the incidence of metabolic differences and organ complications - kidney, heart and blood vessels damage in patients with essential hypertension (EH), PA and its most common forms - idiopathic hyperaldosteronism (IHA) and aldosterone-producing adenoma (APA). We found a higher incidence of metabolic syndrome and a higher incidence of metabolic abnormalities in IHA compared to APA - higher prevalence of metabolic syndrome, higher levels of triglycerides and lower levels of HDL cholesterol and thereby a higher cardiometabolic risk. Metabolic profile of patients with IHA is similar to EH in contrast to APA. Arterial stiffness was expressed as pulse wave velocity (PWV), in central arteries as carotid-femoral PWV and at peripheral level as femoral-ankle PWV. Patients with PA with comparable levels of blood pressure (BP) have higher stiffness of central elastic and peripheral muscular arteries than patients with EH. The main predictor of impaired peripheral arterial stiffness is the plasma aldosterone level. Patients with IHA have higher central arterial...
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Large artery properties in primary and secondary - endocrine hypertension
Rosa, Ján ; Widimský, Jiří (advisor) ; Mlíková Seidlerová, Jitka (referee) ; Špinar, Jindřich (referee)
Arterial stiffness represented by carotid-femoral pulse wave velocity (PWV) is considered to be an independent cardiovascular risk factor. This study was focused on large artery properties investigation in specific forms of hypertension using applanation tonometer Sphygmocor (Atcor Medical). PWV was significantly higher in resistant hypertension patients when compared to moderate essential hypertension (EH) patients. This difference appears to be independent of clinical blood pressure (BP). Night-time BP appears to be a more accurate predictor of PWV in EH. In another study we demonstrated that primary hyperparathyroidism (PH) (both hypertensive or non-hypertensive forms) might be associated with higher PWV when compared to EH patients or to normotensive controls and that this difference is independent of age and clinical BP. Neither calcium serum level, nor parathyroid hormone has been associated with PWV. Specific treatment by parathyroidectomy (PTX) seems to be beneficial for PWV decrease, which might be mainly determined by improved BP control after surgery. Since PTX indications for asymptomatic forms of PH have been discussed, our data suggest the potential benefit to the extent of subclinical organ damage after surgical treatment in these patients. Similarly, we prooved higher PWV in...
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Problems of Keeping Non Pharmacological Treatment Measures by Clients with Arterial Hypertension
FUKOVÁ, Jitka
Hypertension is a very common cardiovascular disease. About 20-25 % of population in developed countries suffer from this problem. Long-term hypertension involves higher risk of myocardial infarction, celebrovascular accident, renal failure or eye problems. The treatment starts from non-farmacological measures connected with healthy living. The patients should stop smoking, reduce sodium, alcohol and animal fat intake, lose weight, avoid stress and improve physical training. The aim of this work is to find out if hypertensive patients know non-pharmacological measures and if they follow them. Two hypotheses were stated at the beginning: A questionnare as a quantitative research strategy was used in this work. The questionnaire consisted of 25 questions. The results were grafically processed. The questionnaire was distributed to hypertensive patients of hospital wards in Písek, cardiological clinic in Písek and general practitioners in Písek and Milevsko. The number of respondents involved in the research was 111. Hypothesis 1: Hypertensive patients do not know non-pharmacological treatment measures. Hypothesis 2: Hypertensive patients do not follow non-pharmacological measures. Analysing the data, hypertensive patients know the non-pharmacological measures very well, hypertensive patients do not follow them. Hypothesis 1 was refuted and hypothesis 2 was proved. The analysis will be offered to cooperative hospital wards and general practitioners so that it can contribute to better secondary prevention of hypertensive patients.
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