Background: Blood pressure (BP) measurement adherence and medication adherence are essential for effective hypertension (HTN) management, particularly in patients with ischemic heart disease. Despite their importance, adherence to these practices remains suboptimal. Methods: We conducted a randomized, prospective double-blind control trial to evaluate the impact of video assisted education on the improvement of home BP measurement (HBPM) and medication adherence in HTN patients with ischemic heart disease. Patients were randomly assigned in a 1:1 ratio to receive either video-based education, or standard education. The co-primary outcomes were HBPM adherence and HTN medication adherence evaluated at 1 month after randomization. The secondary outcomes included changes in office systolic BP (SBP) and diastolic BP (DBP) from baseline to 1-month follow-up and difference of average SBP and DBP between HBPM and 24-hr ambulatory BP measurement (ABPM) between groups. Results: A total of 217 patients were enrolled, with 107 patients randomly assigned to the video-based education group and 110 to the control group. The video-based education group showed numerically higher adherence to HBPM (88.8% vs. 84.7%, p = 0.217) and significantly higher adherence to HTN medication (99.7% vs. 99.1%, p = 0.035) compared to the control group. Optimal medication adherence was significantly more observed in video-based education group (96.3% vs. 83.6%, p=0.002). Non-compliance to the HBPM was significantly lower in the video-based education group (4.7% vs. 12.7%, p=0.036). Changes in office blood pressure from baseline to 1 month were not significantly different between the groups ( p =NS). No significant differences were observed between 24-hour ABPM and home BP in either group (p=NS). Conclusions: Video-based education improved HBPM adherence and HTN medication adherence in patients with ischemic heart disease and HTN.

Background: While sex differences have been observed in various valvular heart diseases, data on rheumatic mitral stenosis, the most common form globally, remain limited. Objective: We sought to determine sex differences in rheumatic mitral stenosis (MS). Methods: From the 3,140 patients in the Multicenter MitrAl STEnosis with Rheumatic etiology (MASTER) registry in South Korea between January 2001 and December 2020, 2,631 patients who were diagnosed with moderate or severe rheumatic MS were included, after excluding those who had undergone prior mitral valve (MV) intervention. Patients were categorized by sex, and we compared demographics, echocardiographic data, and clinical outcomes, including all-cause death, heart failure hospitalization, MV intervention, and ischemic stroke. Results: Among the total population (n=2,631), 74.1% (n=1,950) were women. Compared to men, women were older (60.4 ± 13.0 vs. 58.5 ± 12.2, p<0.001), had a lower prevalence of atrial fibrillation (AF) (50.6 vs. 63.1%, p<0.001), a lower mean diastolic pressure gradient (6.8 ± 3.7 vs. 7.3 ± 4.1 mmHg, p=0.009), and a smaller left ventricular mass index (96.5 ± 29.0 vs. 107.1 ± 34.0 ml/m 2 ). All-cause mortality, heart failure hospitalization, and MV intervention rates were similar between the sexes. However, women had a significantly higher incidence of ischemic stroke compared to men (log-rank p=0.007, Figure 1 ). This finding remained consistent in propensity-matched analysis (p=0.007, Figure 2 ) after adjusting for clinical and echocardiographic variables, including AF. Conclusion: Women with moderate to severe MS had a higher risk of ischemic stroke compared with men. These findings might suggest the need for sex-specific anticoagulation strategies in the management of rheumatic MS.

Background: Blood pressure (BP) measurement adherence and medication adherence are essential for effective hypertension (HTN) management, particularly in patients with ischemic heart disease. Despite their importance, adherence to these practices remains suboptimal. Methods: We conducted a randomized, prospective double-blind control trial to evaluate the impact of video assisted education on the improvement of home BP measurement (HBPM) and medication adherence in HTN patients with ischemic heart disease. Patients were randomly assigned in a 1:1 ratio to receive either video-based education, or standard education. The co-primary outcomes were HBPM adherence and HTN medication adherence evaluated at 1 month after randomization. The secondary outcomes included changes in office systolic BP (SBP) and diastolic BP (DBP) from baseline to 1-month follow-up and difference of average SBP and DBP between HBPM and 24-hr ambulatory BP measurement (ABPM) between groups. Results: A total of 217 patients were enrolled, with 107 patients randomly assigned to the video-based education group and 110 to the control group. The video-based education group showed numerically higher adherence to HBPM (88.8% vs. 84.7%, p = 0.217) and significantly higher adherence to HTN medication (99.7% vs. 99.1%, p = 0.035) compared to the control group. Optimal medication adherence was significantly more observed in video-based education group (96.3% vs. 83.6%, p=0.002). Non-compliance to the HBPM was significantly lower in the video-based education group (4.7% vs. 12.7%, p=0.036). Changes in office blood pressure from baseline to 1 month were not significantly different between the groups ( p =NS). No significant differences were observed between 24-hour ABPM and home BP in either group (p=NS). Conclusions: Video-based education improved HBPM adherence and HTN medication adherence in patients with ischemic heart disease and HTN.

Background: While sex differences have been observed in various valvular heart diseases, data on rheumatic mitral stenosis, the most common form globally, remain limited. Objective: We sought to determine sex differences in rheumatic mitral stenosis (MS). Methods: From the 3,140 patients in the Multicenter MitrAl STEnosis with Rheumatic etiology (MASTER) registry in South Korea between January 2001 and December 2020, 2,631 patients who were diagnosed with moderate or severe rheumatic MS were included, after excluding those who had undergone prior mitral valve (MV) intervention. Patients were categorized by sex, and we compared demographics, echocardiographic data, and clinical outcomes, including all-cause death, heart failure hospitalization, MV intervention, and ischemic stroke. Results: Among the total population (n=2,631), 74.1% (n=1,950) were women. Compared to men, women were older (60.4 ± 13.0 vs. 58.5 ± 12.2, p<0.001), had a lower prevalence of atrial fibrillation (AF) (50.6 vs. 63.1%, p<0.001), a lower mean diastolic pressure gradient (6.8 ± 3.7 vs. 7.3 ± 4.1 mmHg, p=0.009), and a smaller left ventricular mass index (96.5 ± 29.0 vs. 107.1 ± 34.0 ml/m 2 ). All-cause mortality, heart failure hospitalization, and MV intervention rates were similar between the sexes. However, women had a significantly higher incidence of ischemic stroke compared to men (log-rank p=0.007, Figure 1 ). This finding remained consistent in propensity-matched analysis (p=0.007, Figure 2 ) after adjusting for clinical and echocardiographic variables, including AF. Conclusion: Women with moderate to severe MS had a higher risk of ischemic stroke compared with men. These findings might suggest the need for sex-specific anticoagulation strategies in the management of rheumatic MS.

ClinicalTrials.gov Identifier: NCT02579499.

ClinicalTrials.gov Identifier: NCT01947439.

PD could complement resting-RWMA and be a robust predictor of cardiac events in intermediate-risk patients.

This study suggests that using a clinical decision support system can help improve hospital workflows as well as the quality of medical care.

ClinicalTrials.gov Identifier: NCT05933902.