Single-pill combination (SPC) for hypertension is an intensive treatment that can improve a patient's adherence to medication and antihypertensive efficiency. However, few studies have been conducted on the present status and factors that affect adherence to medication and blood pressure control rate in hypertensive patients in the community, who are taking SPC therapy in China.
The present study aims to determine the medication adherence and blood pressure control rate of community hypertension patients using SPC drugs in Huai'an, Jiangsu Province.
The present cross-sectional study was conducted by performing a questionnaire survey to investigate 387 hypertensive patients who took SPC antihypertensive drugs in Huai'an, Jiangsu Province, from June 2022 to December 2022. Multivariate Logistic regression was performed to analyze the factors for blood pressure control, and Pearson's correlation analysis was conducted to determine the relationship among medication adherence, self-efficacy, and medication satisfaction. A structural equation model was established for medication adherence and blood pressure control rate, with self-efficacy and medication satisfaction, in this population (SEM), in order to determine the path relationships among variables.
The blood pressure control rate for the 387 hypertensive patients who took SPC drugs was 32.30%. Furthermore, the proportion of patients who were unmarried/divorced/widowed, and overweight or obese was significantly lower in the blood pressure controlled group, when compared to the blood pressure uncontrolled group (P<0.05). The questionnaire survey results revealed that the medication compliance, self-efficacy, and medication satisfaction scores were significantly higher for patients in the blood pressure controlled group, when compared to those in the blood pressure uncontrolled group [ (6.45±1.10) vs. (6.00±1.50), (32.10±6.65 ) vs. (30.65±6.66), and (52.45±8.83) vs. (48.27±11.85), respectively; P<0.001]. Furthermore, the multivariate Logistic regression analysis results indicated that overweight or obese (OR=1.717, 95%CI=1.058-2.787, P=0.029), medication adherence (OR=1.461, 95%CI=1.202-1.775, P<0.001), self-efficacy (OR=1.052, 95%CI=1.011-1.095, P=0.013), and medication satisfaction (OR=1.025, 95%CI=1.000-1.051, P=0.048) were the factors that affected the blood pressure control rate. The Pearson's correlation analysis results revealed a linear positive correlation among treatment adherence, self-efficacy, and medication satisfaction (r=0.294, 0.226 and 0.280, respectively; P<0.05). The SEM results revealed that both self-efficacy and medication satisfaction were positively correlated to adherence (path coefficient=0.29 and 0.13; P<0.05), and that adherence was positively correlated to the blood pressure control rate (path coefficient=0.15, P<0.05) .
The blood pressure control rate for community hypertensive patients who take SPC drugs remains low. Factors, such as overweight or obese, medication adherence, self-efficacy and medication satisfaction, can influence the blood pressure control rate. Improving the self-efficacy and medication satisfaction of community hypertensive patients who take SPC drugs can effectively improve the medication adherence of patients, and in turn, improve the blood pressure control rate.
Endometriosis (EMT) is a common gynecological disorder. Although Kuntai capsule has been shown to alleviate EMT-related symptoms, its pharmacological and molecular mechanisms remain to be systematically elucidated.
To explore the mechanism of action of Kuntai capsule in the treatment of EMT.
From January 1 to April 30, 2024, the active components and corresponding targets of Kuntai capsule were obtained from the TCMSP, BATMAN-TCM, Pubchem, and SwissTargetPrediction databases. EMT-related disease targets were retrieved from GeneCards, DisGeNET, TTD, OMIM, and Drugbank. A Venn diagram was employed to identify the intersection targets of Kuntai capsule and EMT. The disease-component-target network was constructed using Cytoscape, and the common target protein-protein interaction (PPI) network was built using the STRING database. Topological analysis of the PPI network was performed using Cytoscape to screen for core targets. Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed using the DAVID database. Molecular docking was performed with AutoDockTools. The stability of the optimal binding energy model was further validated using GROMACS molecular dynamics simulations.
A total of 182 common targets were identified. The core components included sitosterol, panicolin, and rivularin. Among them, TNF, GAPDH, and AKT1 were found to play significant roles in the biological network of Kuntai capsule in treating EMT. These core targets were primarily involved in processes such as the negative regulation of apoptosis pathway and oncogenic pathway such as the PI3K-Akt signaling, which plays a ther-apeutic role in EMT. Molecular docking and molecular dynamics simulations further confirmed the stable and tight binding of sitosterol to AKT1.
Kuntai capsule may exert therapeutic effects in EMT by activating multiple signaling pathways through the regulation of core targets such as TNF. These findings not only enhance our understanding of the mechanism of action of Kuntai capsule but also provides new insights into the potential clinical applications of traditional Chinese medicine (TCM) in EMT treatment. Future research can further explore how TCM drugs can intervene in the pathological processes of EMT.
