Treatment Refusal – ABC CARDIOL

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Editorial

From Journals to Bedside: We Must Improve the Compliance with Practice Guidelines

In this issue of “Arquivos Brasileiros de Cardiologia”, Borges et al. described the rate of non-compliance with practice guidelines in a Hospital-based study regarding the use of antiplatelet agents in the perioperative setting of non-cardiac surgery. The authors found an extremely high non-compliance rate of 80.75%, and depicted a significant negative association among non-compliance, patient education level, and the presence of previous myocardial infarction. The authors concluded that local procedures and protocols must be urgently defined.

Perioperative care underwent profound changes in the past decades. Initially, evaluation was limited to issues related to the anesthetic procedures, or to the cancellation of interventions for patients at high risk of complications. Eventually, population aging, the improvement in surgical techniques, and the development of less invasive procedures brought to operation theaters patients at an increased risk of complications, especially cardiovascular ones. Perioperative care specialists had to develop new and interdisciplinary skills to deal with several aspects of medicine, kindly deserving the nickname Chameleon doctor.^–

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Artigo Original

Biopsychosocial variables and attitudes towards treatment influence complicated hypertension

Angela Maria Geraldo Pierin et al. Elaine dos Santos Jesus Mônica Aparecida de Oliveira Augusto Josiane Gusmão … Kátia Ortega Décio Mion Jr

BACKGROUND: Complicated hypertension can be influenced by the characteristics of hypertensive patients. OBJECTIVE: To associate the condition of complicated hypertension with biosocial variables such as attitudes and beliefs about the disease and treatment and subjective well-being. METHODS: We studied 251 uncomplicated hypertensive patients (SBP > 140 mmHg and/or 90 < DBP < 110 mmHg for patients under no treatment and DBP 110 mmHg with or without treatment, with target organ damage or other diseases). RESULTS: Complicated hypertensive patients were significantly different from uncomplicated ones (p <0.05) in relation to: 1 – Prevalence of men, not white (53.0%), higher body mass index (29.5 ± 4.6 vs 28.5 ± 4.0 kg/m²), over 10 years of disease (54.0%), completion of previous treatment (53.0%) and reports of sadness about life as a whole (74.0%) 2 – Complicated hypertensive patients never bring the drugs when they travel (59.0%), nor do they buy them before running out the drugs (71.0%) and rarely follow eating guidelines (69.0%) 3 – Uncomplicated hypertensive patients showed no more migraines, joint pain and, among women, menopausal status and hormone replacement therapy, and 4 – Of those who had pressure control (< 140/90 mmHg), 61.9% were uncomplicated hypertensive patients; and 5 – Complicated hypertensive patients were not aware that treatment can prevent kidney problems and they thought that young people do not have high blood pressure. CONCLUSION: Complicated hypertensive patients showed more negative structural and psychosocial characteristics, more negative attitudes towards treatment and are unaware of the disease.

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From Journals to Bedside: We Must Improve the Compliance with Practice Guidelines

Biopsychosocial variables and attitudes towards treatment influence complicated hypertension

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)