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Hypertension Outreach Program Humber River Regional Hospital Sherry Mariash, RN, CNephC, BScN Gavril Hercz, MD, FRCPC ESRD in GTA (rate/millions) * Above started on dialysis 10 years earlier than Caucasians Source: International Interdisciplinary Conference on Hypertension in Blacks

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Hypertension outreach program humber river regional hospital l.jpg

Hypertension Outreach ProgramHumber River Regional Hospital

Sherry Mariash, RN, CNephC, BScN

Gavril Hercz, MD, FRCPC


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ESRD in GTA (rate/millions)

* Above started on dialysis 10 years earlier than Caucasians

Source: International Interdisciplinary Conference on Hypertension in Blacks



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Encourage regular follow-up and enhance continuum of care

Reduce modifiable risk factors for vascular disease

  • Provide high-risk population with clinical information and educational resources in the community

Build community relationships


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Methods

  • Visible minorities at high risk of ESRD

  • Develop program in the community

  • Liaise with community outreach

  • Empower community in identification and ongoing care

  • Address issue at source

  • Linkages with churches, community centres and schools

  • Word of mouth


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Venues

  • Community Churches

  • Community Centres

  • Shopping Malls


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Team

  • Volunteers

    • Registered Nurses

    • Physician

    • Dieititians

    • Health Ministries


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Lecture/materials

  • Identification of risk factors

  • Hypertension

  • Diabetes

  • Diet/lifestyle modification

  • Treatment modalities

  • Followup with family physician and Health Ministries

  • Pamphlets


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Health Promotion Awareness

  • Blood pressure check

  • Blood glucose check

  • Record of results

  • Counseling

  • Pamphlets


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Measuring Success

  • 9 programs delivered to date

  • Average attendance at each session 50-150

  • Majority are female- carriers of health care information

  • Some clients diagnosed de novo with diabetes and hypertension

  • Large group on therapy and not controlled


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Measuring Successes (cont’d)

  • Partnership with Health Ministries

  • Validates health ministry in congregations

  • Empower clients for regular followup




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Future

  • Motivate other health care facilities to create similar programs in their catchment

  • Enhance education internally of allied health

  • Data collection


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Classification of Hypertension

(Pre Hypertension) 120-139 -- 80-89

*ISH=International Society of Hypertension. Chalmers J et al. J Hypertens 1999;17:151-85.

The category pertains to the highest risk blood pressure


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Benefits of Treating Hypertension

  • Younger than 60

    • reduces the risk of stroke by 42%

    • reduces the risk of coronary event by 14%

  • Older than 60

    • reduces overall mortality by 20%

    • reduces cardiovascular mortality by 33%

    • reduces incidence of stroke by 40%

    • reduces coronary artery disease by 15%


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Leading diagnoses resulting in visits to physician offices in Canada

20

25

20

Routine medical

exams

Depression

Acute respiratory

tract infection

Million visits/year

Diabetes

15

Hypertension

10

10

5

5

0

0

Source: IMS HEALTH Canada 2002. http://www.imshealthcanada.com/


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Hypertensive patients in Canada

who are treated

and BP controlled

Hypertensive patients

who are treated

but BP uncontrolled

13%

9%

21%

Diabetic patients

who are treated and

BP controlled

43%

22%

Patients who are aware

but remain untreated

and BP uncontrolled

Hypertensive patients

who are unaware

Joffres et al. Am J Hyper 2001;14:1099 –1105

The Challenge In Canada

22% of Canadians 18-70 years of age have hypertension

50% of Canadians >65 years of age have hypertension


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