Management of Hypertension and Multiple Risk Factors to Enhance Cardiovascular Health

Launched by DUKE-NUS GRADUATE MEDICAL SCHOOL · Dec 31, 2014

Keywords

ClinConnect Summary

1. Background:

Cardiovascular diseases (CVD) are the leading cause of disability and death in Singapore, and consume substantial healthcare resources. Uncontrolled hypertension confers the highest attributable risk of CVD. About one in four adults suffer from hypertension in Singapore, 50% of them have uncontrolled blood pressure (BP), and management is especially sub-optimal among those with concomitant diabetes or dyslipidemia. Evidence suggests that well structured programs of care delivery are effective in lowering BP and preventing CVD. However, there is lack of empirical data on s...

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Eligibility criteria

• Inclusion Criteria:
• • 40 years or older
• • Singapore citizen and Permanent Resident
• • Individuals visiting the recruiting polyclinic at least twice during the last 1 year
• • Individuals with with previously diagnosed hypertension and uncontrolled blood pressure (Systolic BP 140 mmHg and above and diastolic BP 90 mmHg)
• Exclusion Criteria:
• • Individuals with active systemic illness including fever
• • Individuals with recent hospitalization (i.e. during last 4 months),
• • Individuals with clinically unstable heart failure (i.e. Ejection fraction \<20% or complaint of shortness of breath at rest)
• • Individuals with advanced kidney disease (i.e. estimated Chronic kidney disease (CKD) -Epi glomerular filtration rate \<40 ml/min/1.73m2 or nephrotic range proteinuria (i.e. 3g/d or more))
• • Individuals with known advanced liver disease (i.e. Child-Pugh Stage C)
• • Individuals with pregnancy
• • Individuals with any other major debilitating disease or
• • Individuals with mental illness that precludes validity of informed consent