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Med. clín (Ed. impr.) ; 141(2): 47-52, jul. 2013.
Article in Spanish | IBECS | ID: ibc-114349

ABSTRACT

Fundamento y objetivo: El control de las cifras de presión arterial (PA) se ha estudiado de forma extensa en atención primaria, pero no tanto en el ambiente hospitalario, que incluye las unidades de referencia. El objetivo del estudio ha sido el de examinar el grado de control de la PA en población hipertensa atendida en unidades hospitalarias. Pacientes y método: Se han estudiado 1.550 pacientes hipertensos (41,5% mujeres) con una edad media (DE) de 64 (12) años, en tratamiento farmacológico antihipertensivo. El grado de control se ha estimado en una única visita calculando la proporción de pacientes con cifras de PA inferiores a 140/90 mmHg.Resultados: Un total de 653 pacientes (42%) tenían las cifras de PA controladas. En comparación con ellos, los que no conseguían el control de la PA eran con más frecuencia mujeres (odds ratio [OR] 1,57; intervalo de confianza del 95% [IC 95%] 1,23-1,99), obesos (OR 1,28; IC 95% 1,00-1,63), fumadores (OR 1,78; IC 95% 1,36-2,34), con hipertrofia ventricular izquierda (OR 1,86; IC 95% 1,46-2,36) y tenían cifras elevadas de colesterol (OR 1,50; IC 95% 1,19-1,90) y triglicéridos (OR 1,63; IC 95% 1,29-2,07). La inercia terapéutica se observó en el 39% de los pacientes no controlados. En un subgrupo de 183 pacientes con monitorización ambulatoria de la PA, solo se observó discordancia entre ambas medidas en el 23% (9,8% con hipertensión clínica aislada y 13,1% con hipertensión enmascarada). Conclusión: El grado de control de la PA en población atendida en unidades especializadas se sitúa en el 42% y no ha variado en la última década. Aunque se observa un mayor esfuerzo terapéutico y menor inercia, ello solo sirve para compensar la mayor comorbilidad de los pacientes, lo que dificulta el control de la PA (AU)


Background and objective: Blood pressure (BP) control has been extensively studied in patients attended in primary care but reports in the hospital setting, which includes referral units, are scarce. The aim was to evaluate the degree of BP control in hypertensive patients attended in referral units. Patients and methods: We studied 1,550 hypertensive subjects (41.5% women) with a mean age of 64 (12) years, who were receiving antihypertensive drugs. The degree of BP control was estimated in a single visit by the proportion of patients with BP below 140/90 mmHg. Results: BP was controlled in 653 patients (42%). In comparison, those whose BP was not controlled were more frequently women (odds ratio [OR] 1.57; 95% confidence interval [95%CI]: 1.23-1.99), obese (OR 1.28; 95%CI 1.00-1.63), smokers (OR 1.78; 95%CI 1.36-2.34), had left ventricular hypertrophy (OR 1.86; 95%CI 1.46-2.36) and elevated values of total serum cholesterol (OR 1.50; 95%CI 1.19-1.90) and triglycerides (OR 1.63; 95%CI 1.29-2.07). Therapeutical inertia was observed in 39% of uncontrolled patients. In a subgroup of patients who underwent ambulatory BP monitoring, discordance between measurements was only present in 23% (9.8 with isolated clinic hypertension and 13.1% with masked hypertension). Conclusion: The degree of BP control in patients attended in referral units is estimated in 42% and has not been modified in the last decade. Although therapeutical effort and inertia have improved, this only compensates the increased risk and comorbidities of attended patients, making more difficult the control of BP values (AU)


Subject(s)
Humans , Hypertension/epidemiology , Antihypertensive Agents/therapeutic use , Blood Pressure Monitoring, Ambulatory , Retrospective Studies , /statistics & numerical data , Cardiovascular Diseases/prevention & control , Risk Factors , Comorbidity
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