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      Awareness of Physicians in Yemen Toward High Blood Pressure Management According to the Eighth Joint National Committee (JNC 8) Guideline

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          Abstract

          Background

          Hypertension is a common public health problem that impacts more than one-third of the world population. Awareness of physicians towards the guidelines of high blood pressure management is an essential step to reduce the consequences of high blood pressure.

          Objective

          This study was aimed to assess the awareness of physicians towards high blood pressure treatment according to the recent report of the Joint National Committee (JNC8) guideline.

          Methods

          A self-administered questionnaire was distributed to 400 physicians during the period from February to April 2017. Physicians were recruited from public and private hospitals as well as clinics. A validated questionnaire that incorporated the changes seen in JNC 8, as well as the specific modality of hypertension management based on other guidelines, was administered to the participating physicians.

          Results

          Three hundred and eighty-nine physicians completed the questionnaire; with all the interviewed physicians have ever heard about JNC 8. The practice of general practitioners (GPs) was significantly deviated from the recommended guideline of blood pressure management as compared to consultants, specialists, and residents. Additionally, certain variations were found among consultants, specialists, and residents with slight superiority of consultants towards most aspects.

          Conclusion

          The finding of this study highlights an inadequate knowledge of GPs in Yemen towards high blood pressure management guidelines. The findings of this study emphasize the necessity for continuous medical education programs that are specially designed to target GPs. Continued update of medical curricula in Yemeni universities is also needed.

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          Most cited references23

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          ACOG Practice Bulletin No. 203

          (2019)
          Chronic hypertension is present in 0.9-1.5% of pregnant women () and may result in significant maternal, fetal, and neonatal morbidity and mortality. The rate of maternal chronic hypertension increased by 67% from 2000 to 2009, with the largest increase (87%) among African American women. This increase is largely secondary to the obesity epidemic and increasing maternal age (). The trend is expected to continue.The purpose of this document is to clarify the criteria used to define and diagnose chronic hypertension before or during pregnancy, to review the effects of chronic hypertension on pregnancy and vice versa, and to appraise the available evidence for management options. The purpose of these revised best practice recommendations is to provide a rational approach to chronic hypertension in pregnancy based on new research data and relevant pathophysiologic and pharmacologic considerations.
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            Effects of blood pressure lowering with perindopril and indapamide therapy on dementia and cognitive decline in patients with cerebrovascular disease.

            High blood pressure and stroke are associated with increased risks of dementia and cognitive impairment. This study aimed to determine whether blood pressure lowering would reduce the risks of dementia and cognitive decline among individuals with cerebrovascular disease. The Perindopril Protection Against Recurrent Stroke Study (PROGRESS) was a randomized, double-blind, placebo-controlled trial conducted among 6105 people with prior stroke or transient ischemic attack. Participants were assigned to either active treatment (perindopril for all participants and indapamide for those with neither an indication for nor a contraindication to a diuretic) or matching placebo(s). The primary outcomes for these analyses were dementia (using DSM-IV criteria) and cognitive decline (a decline of 3 or more points in the Mini-Mental State Examination score). During a mean follow-up of 3.9 years, dementia was documented in 193 (6.3%) of the 3051 randomized participants in the actively treated group and 217 (7.1%) of the 3054 randomized participants in the placebo group (relative risk reduction, 12% [95% confidence interval, -8% to 28%]; P =.2). Cognitive decline occurred in 9.1% of the actively treated group and 11.0% of the placebo group (risk reduction, 19% [95% confidence interval, 4% to 32%]; P =.01). The risks of the composite outcomes of dementia with recurrent stroke and of cognitive decline with recurrent stroke were reduced by 34% (95% confidence interval, 3% to 55%) (P =.03) and 45% (95% confidence interval, 21% to 61%) (P<.001), respectively, with no clear effect on either dementia or cognitive decline in the absence of recurrent stroke. Active treatment was associated with reduced risks of dementia and cognitive decline associated with recurrent stroke. These findings further support the recommendation that blood pressure lowering with perindopril and indapamide therapy be considered for all patients with cerebrovascular disease.
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              Global burden of cardiovascular disease and stroke: hypertension at the core.

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                Author and article information

                Journal
                Int J Gen Med
                Int J Gen Med
                ijgm
                ijgm
                International Journal of General Medicine
                Dove
                1178-7074
                21 August 2020
                2020
                : 13
                : 529-537
                Affiliations
                [1 ]Departments of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Science and Technology , Sana’a, Yemen
                [2 ]Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology , Irbid, Jordan
                [3 ]Department of Clinical Pharmacy, Faculty of Pharmacy, Near East University , Nicosia, Cyprus, Turkey
                Author notes
                Correspondence: Mohammed M Battah Tel +967-777404880 Email mmalbattah@gmail.com
                Author information
                http://orcid.org/0000-0002-9026-5656
                http://orcid.org/0000-0002-3126-3327
                http://orcid.org/0000-0002-2808-5099
                Article
                265118
                10.2147/IJGM.S265118
                7450413
                d3ed36eb-2cdc-47ab-aa6e-a95a2cd8c18d
                © 2020 Halboup et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 09 June 2020
                : 05 August 2020
                Page count
                Figures: 0, Tables: 14, References: 38, Pages: 9
                Categories
                Original Research

                Medicine
                hypertension,practitioners,physicians,guidelines,yemen
                Medicine
                hypertension, practitioners, physicians, guidelines, yemen

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