Beruflich Dokumente
Kultur Dokumente
by
by
ABDUL AHAD
FACULTY OF PHARMACY
UNIVERSITY OF BALOCHISTAN, QUETTA.
APPROVAL CERTIFICATE
It is certified that thesis entitled Assessment of Awareness and knowledge of
hypertension in University of Baluchistan Quetta. Submitted by ABDUL AHAD, to
fulfill the requirement of subject clinical pharmacy II as per course of Pharm-D, is his
original work done under my supervision. The matter embodied in this thesis is original
and has not been the submitted or published before.
SUPERVISER
Dr. Noman-Ul-Haq
Assistant Professor
Department of pharmacy practice
Faculty of Pharmacy
University Of Baluchistan, Quetta.
DECLARATION
Internal Examiner:
Dr. Noman-Ul-Haq
Assistant Professor
Department of pharmacy practice
Faculty of Pharmacy
University Of Baluchistan, Quetta.
External Examiner
II
DEDICATION
ACKNOWLEDGEMENT
I would specially thank ALLAH ALMIGHTY who helped me and made this all possible.
This research would never had been completed without Dr. Noman ul Haq, my
supervisor; I would like to thank him for his encouragement, patience and expert
advice. I wish to
Express my thanks to Mr. Aqeel Naseem for his guidance and help. And finally special
thanks go to my friends (Dr.Ashfaq Ahmed, Abdul Hafeez, Abdul Ghaffar, Abdul Bari,
Abdul Rehman, Abdul Ghayas, Qamer Ibrahim, Zaheer Ahmed) and my family members
who have supported me and motivated me throughout my research.
ABBREVIATIONS
AHA
AIRE
HF
Heart failure.
ARB
ACE-I
BP
Blood Pressure.
BB
Beta Blockers.
CVD
CCB
HTN
Hypertension
DBP
EGFR
BUN
BMI
ABPM
HBPM
CKD
BHS
COX-1 & 2
Cycloxygenase-1 & 2.
DASH
DM
Diabetes mellitus.
MI
Myocardial infarction
IHD
JNC-VII
NHS
mmHg
Millimeter mercury.
NSAIDs
ISH
PAD
SBP
SPSS
WHD
WHL
TABLE OF CONTENT
ApprovalCertificate......................................................................................................I
Declaration....................................................................................................................II
Dedication....................................................................................................................III
Acknowledgement ......................................................................................................IV
AbbreviationsV
ABSTRACT..........1
CHAPTER 1: INTRODUCTION...............................................................................3
CHSPTER 2: LITRATURE REVIEW......6
2.1: Hypertension....7
2.1: Hypertension....7
2.3: Classification of blood pressure...9
2.3.1: Primary (essential) hypertension....................................11
2.3.1.1: Neural hypothesis.11
2.3.1.2: Peripheral Auto regulatory Theory..11
2.3.1.3: Renin-Angiotensin-Aldosterone (RAA) hypothesis.12
2.3.1.4: Defective vasopressor mechanisms hypothesis...12
2.3.1.5: Defects in membrane permeability theory...12
2.4: Secondary hypertension.13
2.4.1: Oral contraceptives..13
2.4.2: Renal parenchymal disease..13
S/NO
TITLE
PAGE NO
2.1
Classification of Hypertension
10
4.1
47
4.2
49
4.3
Source group
51
4.4
: Source of information
53
ABSTRACT
BACKGROUND
Hypertension is a major health problem in Pakistan. And the purpose of this study to find
awareness and knowledge among university students.
OBJECTIVE
The present study aimed to evaluate the awareness and knowledge of hypertension in university
of Baluchistan Quetta
METHODOLOGY
This was a cross-sectional study covering 321 students, aged 18-30 years, who answered the
hypertension awareness and knowledge questionnaire a written questionnaire was distributed to
students from different departments of university of Baluchistan during the period from Jun to
august 2014. A self-administered questionnaire was used to get information about demography in
a Yes and No format, and were prepared in English language. All the students were able to
read and write and they filled the questionnaire by themselves. The collected data were
reviewed, coded, verified and statistically analyzed.
Continuous variables were Expressed as mean SD, and mean comparison, and categorical
variables are represented in frequency and percentage. Inferential and statistics (Mann Whitney,
Kruskal-Wallis) test were used to differentiate or relate the study variables. P-value less than
0.05 were considered statistically significant
RESULTS
Three hundred and twenty One students of university of Baluchistan including all department
students were consented to complete the questionnaire. The practices of recent students from all
Departments were better and concomitantly responded the good knowledge near about 85% out
of 321. The knowledge about the range of hypertension in students was about 76%. Eighty three
percent student believe that hypertension occurs due to high salt and fat intake.
CONCLUSION
The findings highlight all students of university of Baluchistan Quetta from different
departments having good knowledge regarding the awareness and knowledgeof hypertension
and needs further more improvement in academic education about the basics of hypertension. .
Chapter 1:
Introduction
unhealthy diets; and smoking have all been demonstrated in young adults. The country also
has an increased prevalence of hypertension 1925%.(Rizwana B. Shaikh)
Knowledge of the predisposing risk factors is vital in the modification of lifestyle
behaviors conducive to optimal cardiovascular health. Measuring and appropriately
disseminating knowledge of the modifiable risk factors at an early age is an essential
preventive educational approach. Strategies to achieve even a modest lowering of the
levels of blood pressure in the population of children and young adults are therefore
important public health goals.(Rizwana B. Shaikh)
Chapter 2:
Literature review
2.1: Hypertension.
Hypertension, also referred to as high blood pressure, is a condition in which the arteries
have persistently elevated blood pressure. Every time the human heart beats, it pumps
blood to the whole body through the arteries. Blood pressure is the force of blood pushing
up against the blood vessel walls. The higher the pressure the harder the heart has to
pump(Collaboration, 2002).
2.2: History
Modern understanding of the cardiovascular system began with the work of
physician William Harvey (15781657), who described the circulation of blood in his book
"De motucordis". The English clergyman Stephen Hales made the first published
measurement of blood pressure in 1733. Descriptions of hypertension as a disease came
among others from Thomas Young in 1808 and especially Richard Bright in 1836. The first
report of elevated blood pressure in a person without evidence of kidney disease was made
by Frederick Akbar Mahomed (18491884). However hypertension as a clinical entity
came
into
being
in
1896
with
the
invention
of
the
cuff-based
Historically the treatment for what was called the "hard pulse disease" consisted in
reducing the quantity of blood by bloodletting or the application of leeches. This was
advocated by The Yellow Emperor of China, Cornelius Celsius, Galen, and Hippocrates. In
the 19th and 20th centuries, before effective pharmacological treatment for hypertension
became possible, three treatment modalities were used, all with numerous side-effects:
strict sodium restriction (for example the rice diet),sympathectomy (surgical ablation of
parts of the sympathetic nervous system), and pyrogenic therapy (injection of substances
that caused a fever, indirectly reducing blood pressure). The first chemical for
hypertension, sodium thiocyanate, was used in 1900 but had many side effects and was
unpopular. Several other agents were developed after the Second World War, the most
popular and reasonably effective of which were tetra methyl ammonium chloride and its
derivative hexamethonium,
from
the
medicinal
plant Rauwolfia serpentina). A major breakthrough was achieved with the discovery of the
first
well-tolerated
orally
available
agents.
The
first
was chlorothiazide,
the
first thiazide diuretic and developed from the antibiotic sulfanilamide, which became
available in 1958. Hypertension can lead to damaged organs, as well as several illnesses,
such as renal failure (kidney failure), aneurysm, heart failure, stroke, or heart attack.
The concept of essential hypertension was introduced in 1925 by the physiologist Otto
Frank to describe elevated blood pressure for which no cause could be found. In 1928, the
term malignant hypertension was coined by physicians from the Mayo Clinic to describe a
syndrome of very high blood pressure, severe retinopathy and adequate kidney function
which usually resulted in death within a year from strokes, heart failure or kidney failure
(Kotchen, 2011)
According to the Standard Treatment Guidelines and Essential Drugs List for South Africa
(Organization, 1983), which are used in primary health care clinics, levels of hypertension
in adults are classified as follows
OF Systolic mmHg
HYPERTENSION
IN
ADULTS
of
Level
Diastolic mmHg
hypertension
Mild
Moderate
Severe
140-159
160-179
180 or more
90-99
100-109
110 or more
10
11
12
Patients with secondary hypertension have a distinct cause and accounts for 5% - 10% of
all hypertension persons. Patients with secondary hypertension are best treated by
controlling or removing the underlying disease or pathology, although they still may
require antihypertensive drugs.
A few identifiable causes of secondary hypertension are as follows:
13
Reno vascular disease is the result of stenosis caused by atherosclerosis of the renal
arteries. Over-activity of the renin-angiotensin mechanism leads to a decrease in renal flow
resulting in high blood pressure For some people on high blood pressure medication- such
as ACE inhibitors the problem may be discovered if side effects such as kidney failure or
other severe kidney problems appear. As a result of high blood pressure the condition
causes some of the following complications: congestive heart failure, heart attack and
stroke (Urden et al., 2006)
14
Confusion
Vision problems
Nausea (Tuck and Corry, 1989)
Other clinical effects only appear until complications develop as a result of vascular
changes in target organs. These include:
The classification Prehypertension, introduced in this report (table 1), recognizes this
relationship and signals the need for increased education of health care professionals and
the public to reduce BP levels and prevent the development of hypertension in the general
population. Hypertension prevention strategies are available to achieve this goal.
17
clinical trials have demonstrated that effective BP control can be achieved in most patients
who are hypertensive, but the majority will require two or more antihypertensive drugs. ,
when clinicians fail to prescribe lifestyle modifications, adequate antihypertensive drug
doses, or appropriate drug combinations, inadequate BP control may result.
2.11.1: Exercise
18
Regular exercise, along with an active lifestyle, may decrease blood pressure. To
significantly reduce the risk of developing high blood pressure, it is recommended that
adults participate in 150 minutes a week of cardiovascular exercise such as walking,
cycling and swimming. Increasing daily activity by walking to and from class and work
(rather than taking the bus) and walking up and down stairs (versus riding the elevator),
will also contribute to an active, healthy lifestyle(Kaplan et al., 1999). Make an
appointment with the McKinley Fitness Specialist at Sport Well Center if you have
questions about blood pressure and exercise.
2.11.2: Nutrition
Research has shown that diet affects the development of high blood pressure
(hypertension). The DASH (Dietary Approaches to Stop Hypertension) eating plan is
recommended if your blood pressure is high or if you are at risk for high blood pressure.
DASH is a combination diet that is low in fat and rich in fruits and vegetables. It is low in
cholesterol and saturated fat, high in dietary fiber, potassium, calcium and magnesium and
moderately high in protein.
DASH includes more than eight servings of fruits and vegetables daily. Fruits and
vegetables that are particularly high in potassium and magnesium are recommended
including:
Apricots
Artichokes
Bananas
Broccoli
Carrots
Dates
Greens
green and lima beans
19
green peas
grapefruit
grapes
mangoes
melons
oranges
peaches
pineapple
potatoes
prunes
raisins
squash
strawberries
sweet potatoes
tangerines
tomatoes(Kaplan et al., 1999)
Two to three servings of low fat dairy products per day contribute calcium and protein to
DASH. Whole grains from cereals, breads and crackers contribute fiber and energy. Lean
meat, poultry and fish (less than six ounces per day) provide more potassium and protein.
To boost potassium, fiber, protein and energy intake even more, DASH recommends nuts,
seeds or cooked dried beans 4-5 times per week.
Healthy weight management and appropriate intake of salt (sodium) are both very
important in blood pressure control. Try to limit the amount of processed and fast food you
eat and take the salt shaker off the table - don't add salt to food after it is cooked. DASH
helps you eat a healthful diet and can also help manage weight.
2.11.3: Alcohol
Alcohol is a drug, and regular over-consumption can raise blood pressure dramatically, as
well as cause an elevation upon withdrawal. Try to limit alcohol to twice a week and drink
20
only 1-2 servings (equivalent to two four-ounce glasses of wine, two eight-ounce glasses of
beer or two shots of spirits).
Also, remember that alcohol intake can be a factor in weight gain. The current
recommendation is to limit alcohol intake to no more than two drinks per day for most men
and no more than one drink per day for women and lighter-weight persons(HIGH).
2.11.4: Stress
The effects of stress can vary, but long-term, chronic stress appears to raise blood pressure.
Various relaxation techniques such as deep breathing, progressive relaxation, massage and
psychological therapy can help to manage stress and help lower stress-induced blood
pressure elevations(Devereux et al., 1983).
2.11.5: Smoking
Smoking is the third leading cause of death in the United States. Smoking causes
peripheral vascular disease (narrowing of the vessels that carry blood to the legs and arms),
as well as hardening of the arteries. These conditions clearly can lead to heart disease and
stroke and are contributing factors in high blood pressure. Don't start smoking and if you
do smoke, seek assistance with quitting(Kaplan et al., 1999).
During adulthood.
Diabetes
Sedentary lifestyle
Lack of physical activity
High levels of salt intake (sodium sensitivity). According to the American Heart
Association (AHA), sodium consumption should be limited to 1,500 milligrams per day,
and that includes everybody, even healthy people without high blood pressure, diabetes or
cardiovascular diseases. AHA's chief executive officer, Nancy Brown said "Our
recommendation is simple in the sense that it applies to the entire U.S population, not just
at-risk groups. Americans of all ages, regardless of individual risk factors, can improve the
heart health and reduce their risk of cardiovascular disease by restricting their daily
consumption of sodium to less those 1,500 milligrams." The recommendation was
published in the journal Circulation (November 5th, 2012 issue)
22
2.13.2:Economics
High blood pressure is the most common chronic medical problem prompting visits
23
to primary health care providers in USA. The American Heart Association estimated
the direct and indirect costs of high blood pressure in 2010 as $76.6 billion. In the
US 80% of people with hypertension are aware of their condition, 71% take some
antihypertensive medication, but only 48% of people aware that they have
hypertension are adequately controlled(Lloyd-Jones et al., 2010). Adequate
management of hypertension can be hampered by inadequacies in the diagnosis,
treatment, and/or control of high blood pressure. Health care providers face many
obstacles to achieving blood pressure control, including resistance to taking multiple
medications to reach blood pressure goals. People also face the challenges of
adhering to medicine schedules and making lifestyle changes. Nonetheless, the
achievement of blood pressure goals is possible, and most importantly, lowering
blood pressure significantly reduces the risk of death due to heart disease and
stroke, the development of other debilitating conditions, and the cost associated with
advanced medical care.(Elliott, 2003)
Quitting smoking.
Eating a healthy diet, including the DASH diet (eating more fruits,
vegetables, and low fat dairy products, less saturated and total fat).
Reducing the amount of sodium in your diet to less than 1,500 milligrams a
24
day if you have high blood pressure. Healthy adults should try to limit their sodium
intake to no more 2,300 milligrams a day (about 1 teaspoon of salt).
Limiting alcohol to two drinks a day for men, one drink a day for
women(Cohen, 2013).
Ascertain patients diet and exercise patterns because a healthy diet and regular
exercise can reduce blood pressure. Offer appropriate guidance and written or
audiovisual materials to promote lifestyle changes.
Education about lifestyle on its own is unlikely to be effective.
Healthy, low-calorie diets had a modest effect on blood pressure in
overweight individuals with raised blood pressure, reducing systolic and
diastolic blood pressure on average by about 56 mmHg in trials. However,
there is variation in the reduction in blood pressure achieved in trials and it
is unclear why. About 40% of patients were estimated to achieve a reduction
in systolic blood pressure of 10 mmHg systolic or more in the short term, up
to 1 year.
Taking aerobic exercise (brisk walking, jogging or cycling) for 3060
minutes, three to five times each week, had a small effect on blood pressure,
reducing systolic and diastolic blood pressure on average by about 23
mmHg in trials. However, there is variation in the reduction in blood
pressure achieved in trials and it is unclear why. About 30% of patients were
estimated to achieve a reduction in systolic blood pressure of 10 mmHg or
25
Encourage patients to keep their dietary sodium intake low, either by reducing or
27
A common aspect of studies for motivating lifestyle change is the use of group
working. Inform patients about local initiatives by, for example, healthcare teams or
patient organizations that provide support and promote healthy lifestyle change.
2.15: Symptoms of hypertension.
There is no guarantee that a person with hypertension will present any symptoms of the
condition. About 33% of people actually do not know that they have high blood pressure,
and this ignorance can last for years. For this reason, it is advisable to undergo periodic
blood pressure screenings even when no symptoms are present. Hypertension is rarely
accompanied by any symptoms, and its identification is usually through screening, or when
seeking healthcare for an unrelated problem. A proportion of people with high blood
pressure reports headaches (particularly at the back of the head and in the morning), as
well as lightheadedness, vertigo tinnitus (buzzing or hissing in the ears), altered vision
or fainting episodes These symptoms however are more likely to be related to
associate anxiety than the high blood pressure itself (Marshall et al., 2012).
Extremely high blood pressure may lead to some symptoms, however, and these include:
Severe headaches
Fatigue or confusion
Dizziness
Nausea
Problems with vision
Chest pains
Breathing problems
Irregular heartbeat
Blood in the urine.
A high blood pressure measurement, however, may be spurious or the result of stress at the
time of the exam. In order to perform a more thorough diagnosis, physicians usually
conduct a physical exam and ask for the medical history of you and your family. Doctors
will need to know if you have any of the risk factors for hypertension, such as smoking,
high cholesterol, or diabetes.
30
2.16.3: Aneroid.
Sphygmomanometers (mechanical types with a dial) are in common use; they require
calibration checks, unlike mercury manometers. Aneroid sphygmomanometers are
considered safer than mercury based, although inexpensive ones are less accurate. [2] A
31
major cause of departure from calibration is mechanical jarring. Aneroid mounted on walls
or stands are not susceptible to this particular problem.
2.16.4: Digital.
Using oscillometric measurements and electronic calculations rather than auscultation.
They may use manual or automatic inflation. These are electronic, easy to operate without
training, and can be used in noisy environments. They measure systolic and diastolic
pressures by oscillometric detection, using a piezoelectric pressure sensor and electronic
components including a microprocessor. They do not measure systolic and diastolic
pressures
directly, per
se,
but
calculate
them
from
the
mean
pressure
32
provided two different readings when checked at the same time. Some of these monitors
also detect irregular heartbeats(Van Montfrans, 2001).
Medical options to treat hypertension include several classes of drugs. ACE inhibitors,
ARB drugs, beta-blockers, diuretics, calcium channel blockers, alpha-blockers, and
peripheral vasodilators are the primary drugs used in treatment. These medications may be
used alone or in combination, and some are only used in combination. In addition, some of
these drugs are preferred to others depending on the characteristics of the patient (diabetic,
pregnant, etc.).
Calcium-channel blockers and cancer risk - postmenopausal females who took calciumchannel blockers for 10 years were found to be 2.5 times more likely to develop breast
cancer compared to women who never took them or those on other hypertension
33
Beetroot
Fennel
Cabbage
Lettuce
Radishes
Carrots.
2.17.3: Yoga.
34
Dr. Debbie Cohen and colleagues from the University of Pennsylvania reported at the
"28th Annual Scientific Meeting" that yoga is effective in reducing blood pressure.
Telemonitoring improves uncontrolled hypertension - researchers reported significant
improvements in the health of hypertensive patients who used telemonitoring, which can
be used at home. Patients use a portable system allowing them to record and send their
blood pressure readings straight to the doctor's office in real time.
"Switching off" high blood pressure in the body - scientists from University of California
San Diego have designed molecules that could eventually be used in medications that
"switch off" high blood.
Diuretics are often recommended as the first line of therapy for most people who have high
blood pressure.
However, your doctor may start a medicine other than a diuretic as the first line of therapy
if you have certain medical problems. For example, ACE inhibitors are often a choice for a
people with diabetes. If one drug doesn't work or is disagreeable, additional medications or
35
alternative medications may be recommended. If your blood pressure is more than 20/10
points higher than it should be, your doctor may consider starting you on two drugs or
placing you on a combination drug.(Cohen, 2013)
36
The major objective is that hypertensive patients must be involved in their treatment and
management of hypertension. They need to have the necessary information about their
condition to empower them to participate in
Their health condition. It is very important to have an open two- way communication
system between the patient and the care giver. One of the important causes of uncontrolled
blood pressure is poor adherence to therapy. If the patient knows about the following
obstacles it will improve adherence to therapy:
Long duration of therapy.
Educate patients about their disease, let them measure blood pressure at home and involve
the family in treatment.
Side-effects of medication, adjust therapy to prevent and minimize side-effects.
Expensive medications, important to keep care inexpensive and simple.
Maintain contact with patients and encourage a positive attitude about the disease
and to achieve their goals.
Encourage lifestyle modifications.
Patients must carry on with their daily living and pill-taking must be integrated in their
routine activities (Seedat and Rayner, 2012)
37
2.20: CONCLUSION
The hypertensive patient need to know what is their risk factors to prevent any further
developing of illnesses or heart disease. It is very important to increase their awareness of
risk factors so that prevention strategies can be implemented early
. According to the (Atkinson and Veriava, 2006) the following can be seen as major risk
factors:
Waist circumference abdominal obesity: Men > 102 cm and Women > 88 cm
The literature review of hypertension, its causes, predisposing problems, management and lifestyle
modifications, as well as knowledge needed by hypertensive patients in the prevention and
treatment of hypertension, served as basis to compile a measuring instrument. It was used
to test the knowledge of people with hypertension regarding cardiovascular risk factors.
The survey or test results would be used to make recommendations and to develop
strategies to help them with risk factor modification and to improve their knowledge. The
end goal would be to decrease the mortality and morbidity rates of hypertensive patients
associated with cardiovascular disease.
Chapter 3:
Methodology
39
3.2: Objective.
Present study is aim to examine the awareness and knowledge of hypertension
the students of Baluchistan university Quetta.
40
towards
41
with the target awareness, two questions with measurement and apparatus, two questions
with the Diagnosis and with the basis of therapy,
42
Chapter 4:
Results
43
44
45
Frequency
percentage
203
65
79.8
20.2
79
110
75
26
30
24.6
34.3
23.4
8.1
9.3
202
119
62.9
37.1
46
The questions are about awareness and knowledge of hypertension. Total questions are 12
only two questions are about 90% and above the students have knowledge. The two
questions are 80% and above. Four questions have a knowledge of 70% and above. The
remaining 4 questions are about 50% and less than.
47
S/
N
Questions
2
3
4
5
6
7
8
9
10
11
12
48
Yes
No
300(93.5
)
280(87.2
)
288(71.0
)
246(76.6
)
233(72.6
)
303(94.4
)
246(76.6
)
222(66.2
)
185(57.6
)
268(83.5
)
190(59.2
)
213(66.4
)
18(5.6)
Dont
know
3(0.9)
28(8.7)
13(4.0)
71(22.1
)
53(16.5
)
54(16.8
)
14(4.4)
22(6.9)
44(13.7
)
50(15.6
)
84(26.2
)
35(10.9
)
69(21.5
)
46(14.3
)
31(9.7)
22(6.9)
34(10.6
)
4(1.2)
49(15.3
)
52(16.2
)
18(5.6)
62(19.3
)
62(19.3
)
The students involve in good knowledge having a frequency of 273 with percentage of
85.0 and the students having the poor knowledge with a frequency of 48 and percentage is
15.0. The table is as follow.
SCORE GROUP
Good Knowledge
273
85.0
Poor Knowledge
48
15.0
50
51
Academic learning
162
50.5
News paper
73
22.7
Internet
60
18.7
12
3.7
Health worker
84
26.2
Chapter 5:
Discussion
52
53
This study conducts the descriptive survey to understand the current status of knowledge
and awareness of hypertension in university of Baluchistan Quetta. Our results suggest that
the students are aware of HTN in general, but are less aware of HTN about specific factors
related to their condition, which is also reported by oliveria et al according to which
majority of correspondents are aware about hypertension but are not aware about the
factors related to it (Oliveria et al., 2005).
The study also indicates that a quarter of study correspondents are not aware that life style
changes can also effect hypertension which in line to finding by oliveria et (Oliveria et al.,
2005) according to findings by oliveria et al large number of people are not aware that
changing their life style can affect their hypertension. Efforts to educate the public that
lifestyle modifications can prevent hypertension (Viera et al., 2008).
More than 50% of the correspondents knew that hypertension could lead to cardio vascular
problems which is according to research findings by aliinger et al (Ailinger, 1982)Aliinger
et al reported that half of his study subjects were aware of the cardiovascular sequel of
hypertension.
Ninety percent of people agree that high blood pressure is dangerous to health which is in
line to the established facts (BPA, 2008) according to Blood pressure association UK over
a period of years, the blood pressure remains high and starts to damage the blood vessels.
This is when the damage to the blood vessels can lead to a heart attack, stroke, heart failure
or kidney disease.
Some twenty percent of the people responded negatively when asked if antihypertensive
drugs could control hypertension. This might be due to their past experiences or
54
inefficiency of the medication they or their relatives are using. If a person is having
hypertension and he is using medicine of an in effective brand or company (which may be
due to less amount of active ingredient then specified) or counterfeit then such patients
dont get cured as a consequence the relatives or people around these patients start having
a disbelief in medicines and they start believing that hypertension cannot be cured using
anti-hypertensive drugs.
The dietary factors were also addressed in the questionnaire two quarter of the people
agreed that increasing salt intake can elevate hypertension. The raised blood pressure
caused by eating too much salt may damage the arteries leading to the brain (BPA, 2008).
At first, it may cause a slight reduction in the amount of blood reaching the brain. This
may lead to dementia (known as vascular dementia) (BPA, 2008).
Study correspondents response show that a considerable number of people know about the
sphygmomanometer and stethoscope which may imply that the amount of hypertensive
patients in our society is exceedingly increasing.
Even though, the rate of awareness towards hypertension is quite prominent from 62% in
Australia to 72% in US, the control rates are quite discouraging as with to 24% and 35%
respectively. In the South Asian region, the scenario is more threatening as China reported
only 8% control rates and India with 6% in management of hypertension. At present, it is
estimated that about 1 billion people worldwide have hypertension (>140/90 mmHg), and
this number is expected to increase to 1.56 billion by 2025 (Saleem et al., 2010).
The correspondents were also asked if the Blood pressure of a person is measured in sitting
position. More than seventy percent people said yes. However Different arm positions
55
below heart level have significant effects on blood pressure readings (Adiyaman et al.,
2006). Adiyamanet all also reported that he leading guidelines about arm position during
blood pressure measurement are not in accordance with the arm position used in the
Framingham study, the most frequently used study for risk estimations.
When asked is hypertension a curable disease, almost a quarter of study correspondents
disagreed. This might be due to the de centralized cause of hypertension as there is no one
known cause or causative agent the treatment normally includes a wide variety of
medication life style changes and diet changes In most cases, its impossible to pinpoint an
exact cause of high blood pressure. There are, however, a number of factors that have been
linked to high blood pressure (Vascular cures, 2013). this implies that treating homeopathy
(alternative medicines) requires a wide range of issues to be addressed both
pharmacologically and non-pharmacologically.
The potential feature study of awareness and knowledge of hypertension is that it chooses
a very important part of the society which had been neglected before. Therefore the above
mention study has been conducted.
56
Chapter6:
Conclusion
57
Result and discussion shows that enormous proportions of students have knowledge and
awareness regarding hypertension without necessarily preceding its updated knowledge in
provided recommendations. Extent of knowledge regarding hypertension the variables of
B.P range and diagnosis of hypertension mentioned as patients B.P range and devices used
for measurement, was calculated partially,
Rest of participants from science faculty. The participants from Arts faculty has poor
knowledge which may represent their inappropriate knowledge due to their academic
courses and lake of information provided them regarding science or disease, as the
hypertension known to be a silent killer which needs awareness among the population.
As the poor knowledge of Arts faculty participants is concerned represent the lake of
facility of sources, awareness programs in Quetta city and conducting / attending any
seminar regarding health care problems etc.
58
Recommendation.
The method of collecting data must be improved to get more respondents, so that the
results will be more reliable. Web based survey might be applied by email the
questionnaires to all graduates and they will reply the answer. In addition, respondents will
not answer the questions in hurry. There should be conduction of seminar or such programs
regarding awareness and knowledge to all students of University of Baluchistan regarding
hypertension or any other life threatening disease etc.so that all the youngsters are aware of
hypertension a silent killer disease of mankind to be prevented and treated.
59
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