Araştırma Makalesi
BibTex RIS Kaynak Göster

Aile hekimliği polikliniğine başvuran hastalarda vücut kitle indeksi ve anksiyete durumunun kan basıncı üzerine etkisi

Yıl 2022, Cilt: 7 Sayı: 4, 109 - 117, 19.10.2022
https://doi.org/10.22391/fppc.1039824

Öz

Giriş: Hipertansiyon, kontrol altına alınmadığı takdirde veya etkin tedavi edilmediğinde birçok morbidite ve mortaliteye neden olabilen dünyada önlenebilir ölüm nedenleri arasında ilk sıralarda yer alan küresel bir halk sağlığı sorunudur. Birçok çalışmada hipertansiyonu etkileyen faktörler arasında anksiyete ve vücut kitle indeksinin yer aldığı belirlenmiştir. Bununla birlikte anksiyete ve hipertansiyon ilişkisi açısından birçok çalışmada farklı sonuçlar elde edilmiştir. Bu çalışma, Dicle Üniversitesi Tıp Fakültesi Aile Hekimliği polikliniğine başvuran hastalarda vücut kitle indeksi ve anksiyete durumunun kan basıncı üzerine etkisini ve kan basıncı üzerine etki eden faktörleri değerlendirmek amacıyla yapılmıştır.

Yöntem: Kesitsel tipte olan bu çalışmaya, Dicle Üniversitesi Tıp Fakültesi Aile Hekimliği Polikliniğine 01.04.2018 ve 01.07.2018 tarihleri arasında başvuran 18- 65 yaş arası 403 hasta dahil edilmiştir. Çalışmanın evreni çalışmanın yürütüldüğü il, gücü %80 olacak şekilde örneklem hacmi hesaplanmıştır. Hastaların vücut kitle indeksleri ve Beck anksiyete ölçeğinden aldıkları anksiyete skorları hesaplanıp arteriyel kan basıncı ölçümleri yapıldı. Hastaların VKİ ve Beck anksiyete puanları ile kan basınçları arasındaki ilişki incelenmiştir.

Bulgular: Katılımcıların, %50.1’i erkek, %49.9’u kadın, yaş ortalaması 34.11’di. Hastaların vücut kitle indeksi(VKİ) ortalaması 25.52 kg/m², anksiyete skor ortalaması 7.40, arteriyel kan basınçları ortalama 117.80/75.54 mmHg olarak hesaplandı. VKİ grubu ilerledikçe kan basınçlarının anlamlı şekilde arttığı belirlendi. Anksiyete şiddeti ile sistolik kan basıncı arasındaki ilişki anlamlı iken, diastolik kan basıncı ile arasındaki ilişki anlamlı bulunmadı. VKİ ve anksiyete skorunun sistolik ve diastolik kan basıncı değerleriyle pozitif korelasyonu olduğu bulundu.

Sonuç: Bu çalışma sonucunda VKİ ve Beck anksiyete skorunun artışının kan basıncında artışla ilişkili olabileceği bulundu. Bu sonuç, birinci basamakta anksiyete, obezite ve hipertansiyon gibi sık karşılaşılan sağlık sorunlarının birbirine eşlik edebileceğini ve aile hekimliği bakış açısı ve biyopsikososyal yaklaşımla hipertansiyon ve komplikasyonlarıyla etkili mücadele edilebileceğini göstermiştir.

Anahtar Kelimeler: Anksiyete, Hipertansiyon, Kan Basıncı, Obezite, Vücut Kitle İndeksi

Kaynakça

  • 1. World Health Organization, International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. Journal of Hypertension. 2003;21(11):1983-92. https://doi.org/10.1097/00004872-200311000-00002
  • 2. [Hypertension diagnosis and treatment guide] (in Turkish) . Turkish Society of Endocrinology and Metabolism. 2018. Available at http://temd.org.tr/guides (Access Date: October 7, 2022)
  • 3. Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104(22):2746-53. https://doi.org/10.1161/hc4601.099487
  • 4. Khor GL. Cardiovascular epidemiology in the Asia-Pacific region. Asia Pac J Clin Nutr. 2001;10(2):76-80. https://doi.org/10.1046/j.1440-6047.2001.00230.x
  • 5. Vorster HH. The emergence of cardiovascular disease during urbanisation of Africans. Public Health Nutr. 2002;5(1a):239-43. https://doi.org/10.1079/PHN2001299
  • 6. Psaty BM, Manolio TA, Smith NL, et al. Time trends in high blood pressure control and the use of antihypertensive medications in older adults: The Cardiovascular Health Study. Arch Intern Med. 2002;162(20):2325-32. https://doi.org/10.1001/archinte.162.20.2325
  • 7. Marques-Vidal P, Tuomilehto J. Hypertension awareness, treatment and control in the community: is the 'rule of halves' still valid?. J Hum Hypertens. 1997;11(4):213-20. https://doi.org/10.1038/sj.jhh.1000426
  • 8. Klungel OH, de Boer A, Paes AH, Seidell JC, Nagelkerke NJ, Bakker A. Undertreatment of hypertension in a population-based study in The Netherlands. J Hum Hypertens. 1998;16(9):1371-8. https://doi.org/10.1097/00004872-199816090-00018
  • 9. Trilling JS, Froom J. The urgent need to improve hypertension care. Arch Fam Med. 2000;9(9):794-801. https://doi.org/10.1001/archfami.9.9.794
  • 10. Zhou B., Perel P., Mensah G. A., Ezzati M. Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nature Reviews Cardiology. 2021;18(11):785-802.
  • 11. Zhou B., Carrillo-Larco R M, Danaei G, et al. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021;398(10304): 957-80. https://doi.org/10.1016/s0140-6736(21)01330-1
  • 12. Byrd JB, Brook RD. Anxiety in the "age of hypertension". Curr Hypertens Rep. 2014;16:1-7. https://doi.org/10.1007/s11906-014-0486-0
  • 13. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893-7. https://doi.org/10.1037/0022-006X.56.6.893
  • 14. Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. J Cogn Psychother.1998;12(2):163-72.
  • 15. Aydogan U, Mutlu S, Akbulut H, Tas G, Aydogdu A, Saglam K. [Anxiety disorder in hypertension patients] (in Turkish) Konuralp Med J. 2012;4(2):1-5. Available at https://dergipark.org.tr/en/pub/ktd/issue/10303/126402 (Access Date: October 7, 2022)
  • 16. Paterniti S, Alperovitch A, Ducimetiere P, Dealberto MJ, Lépine JP, Bisserbe JC. Anxiety but not depression is associated with elevated blood pressure in a community group of French elderly. Psychosom Med. 1999;61:77-83. https://doi.org/10.1097/00006842-199901000-00013
  • 17. Nielsen GA, Andersen LB. The association between high blood pressure, physical fitness, and body mass index in adolescents. Prev Med. 2003;36:229-34. https://doi.org/10.1016/S0091-7435(02)00017-8
  • 18. Tanyeri F, Topbas M, Dundar C, Dilek M, Peksen Y. [The relationship between obesity prevalence and obesity arterial blood pressure in Samsun city center] (in Turkish) J Exp Clin Med. 1999;17(2):69-77.
  • 19. Akman M, Budak S, Kendir M. [Prevalence of obesity and related health problems in patients admitted to the general internal medicine outpatient clinic] (in Turkish) Marmara Med J. 2004;17(3):113-120.
  • 20. Räikkönen K, Matthews KA, Kuller LH. Trajectory of psychological risk and incident hypertension in middle-aged women. Hypertension. 2001;38:798-802. https://doi.org/10.1161/hyp.38.4.798 .
  • 21. Tasci S, Ozturk A, Ozturk Y. [The prevalence of hypertension in the population over 30 years of age in the Kiranardi region of Hisarcik Ahmet Karamanci Health Center and affecting factors] (in Turkish) Health Sci J Supplementary Issue Nurs Special Issue. 2005;14:59-65.
  • 22. Sparrow D, Garvey AJ, Rosner B, Thomas HE. Factors in predicting blood pressure change. Circ 1982;65(4):789-94. https://doi.org/10.1161/01.CIR.65.4.789
  • 23. Markovitz JH, Matthews KA, Wing RR, Kuller LH, Meilahn EN. Psychological, biological and health behavior predictors of blood pressure changes in middle-aged women. J Hypertens. 1991;9(5):399-406. https://doi.org/10.1097/00004872-199105000-00003
  • 24. Tesfaye F, Nawi NG, Van Minh H, et al. Association between body mass index and blood pressure across three populations in Africa and Asia. J Hum Hypertens. 2007;21:28-37. https://doi.org/10.1038/sj.jhh.1002104
  • 25. Hekimsoy Z, Ak G, Dolu D, Toprak O, Aslan L. [Frequency of Impaired Fasting Glucose, Impaired Glucose Tolerance, Diabetes Mellitus and Hypertension in Obese Female Patients] (in Turkish) Turkiye Klinikleri J Med Sci. 2001;21:285-7.
  • 26. Hatemi H, Yumuk VD, Turan N, Arik N. Prevalence of overweight and obesity in Turkey. Metab Syndr Relat Disord. 2003;1(4):285-90. https://doi.org/10.1089/1540419031361363
  • 27. Nazlıcan E, Demirhindi H, Akbaba M. [Investigation of obesity and related risk factors in women aged 20-64 living in Adana Province Solakli and Karatas Central Health Center Region] (in Turkish). J DU Health Sci Inst. 2011;1(2):5-12.
  • 28. Aladag N, Cigerli O, Topsever P, Topalli R, Gorpelioglu S, Filiz TM. [The prevalence of obesity in adult patients admitted to the Degirmendere Family Medicine outpatient clinic and its relationship with comorbidities: a case-control study] (in Turkish) Turk J Fam Prac 2003;7(3):117-21.
  • 29. Kutluturk F, Ozturk B, Yildirim B, et al. [The prevalence of obesity and its relationship with metabolic risk factors: A prevalence study in Tokat province] (in Turkish) Turkiye Klinikleri J Med Sci. 2011;31(1):156-63. https://doi.org/10.5336/medsci.2009-14563
  • 30. Hildrum B, Mykletun A, Stordal E, Bjelland I, Dahl AA, Holmen J. Association of low blood pressure with anxiety and depression: the NordTrøndelag Health Study. J Epidemiol Community Health. 2007;61:53-8. https://doi.org/10.1136/jech.2005.044966
  • 31. Jonas BS, Franks P, Ingram DD. Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Arch Fam Med. 1997;6:43-9. https://doi.org/10.1001/archfami.6.1.43
  • 32. Shinn EH, Poston WSC, Kimball KT, Jeor ST, Foreyt JP. Blood pressure and symptoms of depression and anxiety: a prospective study. Am J Hypertens. 2001;14:660-4. https://doi.org/10.1016/S0895-7061(01)01304-8

The effect of body mass index and anxiety status on blood pressure in patients admitted to family medicine outpatient clinic

Yıl 2022, Cilt: 7 Sayı: 4, 109 - 117, 19.10.2022
https://doi.org/10.22391/fppc.1039824

Öz

Introduction: Hypertension is a global public health problem that is the leading cause of preventable death in the world and a disease which can cause many morbidities and mortality if not controlled or treated effectively. In many studies, it has been determined that anxiety and body mass index(BMI) are among the factors affecting hypertension. However, different results have been obtained in many studies in terms of the relationship between anxiety and hypertension. This study was carried out with the aim to evaluate the effect of body mass index and anxiety on blood pressure and the factors affecting blood pressure in patients who applied to outpatient clinic of family medicine at Dicle University Faculty of Medicine.

Methods: 403 patients aged between 18- 65 years, who applied to outpatient clinic of family medicine at Dicle University Faculty of Medicine between 01.04.2018 and 01.07.2018, were included in this cross-sectional study. The population of the study was the province where the study was carried out, and the sample size was calculated with a power of 80%. The patients' body mass index and anxiety scores from Beck anxiety scale were calculated and measurements of arterial blood pressure were performed. The relationship between BMI, Beck anxiety scores and blood pressure of patients were investigated.

Results: Of the participants, 50.1% were male, 49.9% were female and the average age was 34.11 in years. Of the patients, the mean BMI as 25.52 kg/m², the mean anxiety score as 7.40 and the arterial blood pressures as 117.80/75.54 mmHg were measured. It was found that arterial blood pressure raised significantly as the BMI group increased. While the relationship between the severity of anxiety and systolic blood pressure was significant, its relationship with diastolic blood pressure was not significant. There was a positive correlation between BMI, anxiety score and systolic and diastolic blood pressure.

Conclusions: According to the results of this study, it was found that the increase in BMI and Beck anxiety scores may be related with increase in arterial blood pressure. This result showed that common health problems in primary care such as anxiety, obesity and hypertension may be associated with each other, and it can be effectively fought against hypertension and its complications with the perspective of family medicine and biopsychosocial approach.

Keywords: Anxiety, Hypertension, Blood Pressure, Obesity, Body Mass Index

Kaynakça

  • 1. World Health Organization, International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. Journal of Hypertension. 2003;21(11):1983-92. https://doi.org/10.1097/00004872-200311000-00002
  • 2. [Hypertension diagnosis and treatment guide] (in Turkish) . Turkish Society of Endocrinology and Metabolism. 2018. Available at http://temd.org.tr/guides (Access Date: October 7, 2022)
  • 3. Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104(22):2746-53. https://doi.org/10.1161/hc4601.099487
  • 4. Khor GL. Cardiovascular epidemiology in the Asia-Pacific region. Asia Pac J Clin Nutr. 2001;10(2):76-80. https://doi.org/10.1046/j.1440-6047.2001.00230.x
  • 5. Vorster HH. The emergence of cardiovascular disease during urbanisation of Africans. Public Health Nutr. 2002;5(1a):239-43. https://doi.org/10.1079/PHN2001299
  • 6. Psaty BM, Manolio TA, Smith NL, et al. Time trends in high blood pressure control and the use of antihypertensive medications in older adults: The Cardiovascular Health Study. Arch Intern Med. 2002;162(20):2325-32. https://doi.org/10.1001/archinte.162.20.2325
  • 7. Marques-Vidal P, Tuomilehto J. Hypertension awareness, treatment and control in the community: is the 'rule of halves' still valid?. J Hum Hypertens. 1997;11(4):213-20. https://doi.org/10.1038/sj.jhh.1000426
  • 8. Klungel OH, de Boer A, Paes AH, Seidell JC, Nagelkerke NJ, Bakker A. Undertreatment of hypertension in a population-based study in The Netherlands. J Hum Hypertens. 1998;16(9):1371-8. https://doi.org/10.1097/00004872-199816090-00018
  • 9. Trilling JS, Froom J. The urgent need to improve hypertension care. Arch Fam Med. 2000;9(9):794-801. https://doi.org/10.1001/archfami.9.9.794
  • 10. Zhou B., Perel P., Mensah G. A., Ezzati M. Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nature Reviews Cardiology. 2021;18(11):785-802.
  • 11. Zhou B., Carrillo-Larco R M, Danaei G, et al. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021;398(10304): 957-80. https://doi.org/10.1016/s0140-6736(21)01330-1
  • 12. Byrd JB, Brook RD. Anxiety in the "age of hypertension". Curr Hypertens Rep. 2014;16:1-7. https://doi.org/10.1007/s11906-014-0486-0
  • 13. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893-7. https://doi.org/10.1037/0022-006X.56.6.893
  • 14. Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. J Cogn Psychother.1998;12(2):163-72.
  • 15. Aydogan U, Mutlu S, Akbulut H, Tas G, Aydogdu A, Saglam K. [Anxiety disorder in hypertension patients] (in Turkish) Konuralp Med J. 2012;4(2):1-5. Available at https://dergipark.org.tr/en/pub/ktd/issue/10303/126402 (Access Date: October 7, 2022)
  • 16. Paterniti S, Alperovitch A, Ducimetiere P, Dealberto MJ, Lépine JP, Bisserbe JC. Anxiety but not depression is associated with elevated blood pressure in a community group of French elderly. Psychosom Med. 1999;61:77-83. https://doi.org/10.1097/00006842-199901000-00013
  • 17. Nielsen GA, Andersen LB. The association between high blood pressure, physical fitness, and body mass index in adolescents. Prev Med. 2003;36:229-34. https://doi.org/10.1016/S0091-7435(02)00017-8
  • 18. Tanyeri F, Topbas M, Dundar C, Dilek M, Peksen Y. [The relationship between obesity prevalence and obesity arterial blood pressure in Samsun city center] (in Turkish) J Exp Clin Med. 1999;17(2):69-77.
  • 19. Akman M, Budak S, Kendir M. [Prevalence of obesity and related health problems in patients admitted to the general internal medicine outpatient clinic] (in Turkish) Marmara Med J. 2004;17(3):113-120.
  • 20. Räikkönen K, Matthews KA, Kuller LH. Trajectory of psychological risk and incident hypertension in middle-aged women. Hypertension. 2001;38:798-802. https://doi.org/10.1161/hyp.38.4.798 .
  • 21. Tasci S, Ozturk A, Ozturk Y. [The prevalence of hypertension in the population over 30 years of age in the Kiranardi region of Hisarcik Ahmet Karamanci Health Center and affecting factors] (in Turkish) Health Sci J Supplementary Issue Nurs Special Issue. 2005;14:59-65.
  • 22. Sparrow D, Garvey AJ, Rosner B, Thomas HE. Factors in predicting blood pressure change. Circ 1982;65(4):789-94. https://doi.org/10.1161/01.CIR.65.4.789
  • 23. Markovitz JH, Matthews KA, Wing RR, Kuller LH, Meilahn EN. Psychological, biological and health behavior predictors of blood pressure changes in middle-aged women. J Hypertens. 1991;9(5):399-406. https://doi.org/10.1097/00004872-199105000-00003
  • 24. Tesfaye F, Nawi NG, Van Minh H, et al. Association between body mass index and blood pressure across three populations in Africa and Asia. J Hum Hypertens. 2007;21:28-37. https://doi.org/10.1038/sj.jhh.1002104
  • 25. Hekimsoy Z, Ak G, Dolu D, Toprak O, Aslan L. [Frequency of Impaired Fasting Glucose, Impaired Glucose Tolerance, Diabetes Mellitus and Hypertension in Obese Female Patients] (in Turkish) Turkiye Klinikleri J Med Sci. 2001;21:285-7.
  • 26. Hatemi H, Yumuk VD, Turan N, Arik N. Prevalence of overweight and obesity in Turkey. Metab Syndr Relat Disord. 2003;1(4):285-90. https://doi.org/10.1089/1540419031361363
  • 27. Nazlıcan E, Demirhindi H, Akbaba M. [Investigation of obesity and related risk factors in women aged 20-64 living in Adana Province Solakli and Karatas Central Health Center Region] (in Turkish). J DU Health Sci Inst. 2011;1(2):5-12.
  • 28. Aladag N, Cigerli O, Topsever P, Topalli R, Gorpelioglu S, Filiz TM. [The prevalence of obesity in adult patients admitted to the Degirmendere Family Medicine outpatient clinic and its relationship with comorbidities: a case-control study] (in Turkish) Turk J Fam Prac 2003;7(3):117-21.
  • 29. Kutluturk F, Ozturk B, Yildirim B, et al. [The prevalence of obesity and its relationship with metabolic risk factors: A prevalence study in Tokat province] (in Turkish) Turkiye Klinikleri J Med Sci. 2011;31(1):156-63. https://doi.org/10.5336/medsci.2009-14563
  • 30. Hildrum B, Mykletun A, Stordal E, Bjelland I, Dahl AA, Holmen J. Association of low blood pressure with anxiety and depression: the NordTrøndelag Health Study. J Epidemiol Community Health. 2007;61:53-8. https://doi.org/10.1136/jech.2005.044966
  • 31. Jonas BS, Franks P, Ingram DD. Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Arch Fam Med. 1997;6:43-9. https://doi.org/10.1001/archfami.6.1.43
  • 32. Shinn EH, Poston WSC, Kimball KT, Jeor ST, Foreyt JP. Blood pressure and symptoms of depression and anxiety: a prospective study. Am J Hypertens. 2001;14:660-4. https://doi.org/10.1016/S0895-7061(01)01304-8
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Araştırma Makalesi (Original Article)
Yazarlar

Orhan Ayan 0000-0003-4009-1157

Ahmet Yılmaz 0000-0002-2648-2824

Ahmet Dündar 0000-0003-0527-189X

Vasfiye Demir Pervane 0000-0003-0985-4259

Mahir Kuyumcu 0000-0003-4023-2976

Yayımlanma Tarihi 19 Ekim 2022
Gönderilme Tarihi 3 Ocak 2022
Kabul Tarihi 15 Ağustos 2022
Yayımlandığı Sayı Yıl 2022Cilt: 7 Sayı: 4

Kaynak Göster

APA Ayan, O., Yılmaz, A., Dündar, A., Demir Pervane, V., vd. (2022). The effect of body mass index and anxiety status on blood pressure in patients admitted to family medicine outpatient clinic. Family Practice and Palliative Care, 7(4), 109-117. https://doi.org/10.22391/fppc.1039824
AMA Ayan O, Yılmaz A, Dündar A, Demir Pervane V, Kuyumcu M. The effect of body mass index and anxiety status on blood pressure in patients admitted to family medicine outpatient clinic. Fam Pract Palliat Care. Ekim 2022;7(4):109-117. doi:10.22391/fppc.1039824
Chicago Ayan, Orhan, Ahmet Yılmaz, Ahmet Dündar, Vasfiye Demir Pervane, ve Mahir Kuyumcu. “The Effect of Body Mass Index and Anxiety Status on Blood Pressure in Patients Admitted to Family Medicine Outpatient Clinic”. Family Practice and Palliative Care 7, sy. 4 (Ekim 2022): 109-17. https://doi.org/10.22391/fppc.1039824.
EndNote Ayan O, Yılmaz A, Dündar A, Demir Pervane V, Kuyumcu M (01 Ekim 2022) The effect of body mass index and anxiety status on blood pressure in patients admitted to family medicine outpatient clinic. Family Practice and Palliative Care 7 4 109–117.
IEEE O. Ayan, A. Yılmaz, A. Dündar, V. Demir Pervane, ve M. Kuyumcu, “The effect of body mass index and anxiety status on blood pressure in patients admitted to family medicine outpatient clinic”, Fam Pract Palliat Care, c. 7, sy. 4, ss. 109–117, 2022, doi: 10.22391/fppc.1039824.
ISNAD Ayan, Orhan vd. “The Effect of Body Mass Index and Anxiety Status on Blood Pressure in Patients Admitted to Family Medicine Outpatient Clinic”. Family Practice and Palliative Care 7/4 (Ekim 2022), 109-117. https://doi.org/10.22391/fppc.1039824.
JAMA Ayan O, Yılmaz A, Dündar A, Demir Pervane V, Kuyumcu M. The effect of body mass index and anxiety status on blood pressure in patients admitted to family medicine outpatient clinic. Fam Pract Palliat Care. 2022;7:109–117.
MLA Ayan, Orhan vd. “The Effect of Body Mass Index and Anxiety Status on Blood Pressure in Patients Admitted to Family Medicine Outpatient Clinic”. Family Practice and Palliative Care, c. 7, sy. 4, 2022, ss. 109-17, doi:10.22391/fppc.1039824.
Vancouver Ayan O, Yılmaz A, Dündar A, Demir Pervane V, Kuyumcu M. The effect of body mass index and anxiety status on blood pressure in patients admitted to family medicine outpatient clinic. Fam Pract Palliat Care. 2022;7(4):109-17.

Family Practice and Palliative Care      ISSN 2458-8865       E-ISSN 2459-1505