[Knowledge level of hypertensive patients about hypertension. Relationship between knowledge level and hypertension control]. / Estudio Conocimiento: grado de conocimiento sobre hipertensión arterial de nuestros pacientes. Relación con el nivel de control de la misma.

OBJECTIVE: To assess the knowledge of the hypertensive patients about their hypertension and their relation to its control. MATERIAL AND METHODS: Cross-sectional study among 400 hypertensive patients, all over 18 years, selected from 50 primary-care centres, who responded to an hypertension-related survey. Included variables were survey items, age, gender, educational level, professional occupation, blood pressure data and antihypertensive treatment. The obtained differences were analyzed using the chi-square test, Kruskal-Wallis, Wilcoxon, Anova and Bonferroni methods. RESULTS: There were 323 valid surveys. 52.9% of respondents were women, the average age: 65.4 years (SD: 11.2), 54.8% of them had primary education. 39.6% were aware of the objectives of systolic BP control. Only 19.6% having knowledge of those for diastolic BP control, with no differences between controlled and uncontrolled (systolic BP: 39% vs 38.1%, P=.887; diastolic BP: 19.2% vs 21%, P=.721). Over 70% knew about lifestyle changes, without significant differences between controlled and uncontrolled respondents. 82% of controlled respondents, and 79% of those uncontrolled, recognized the chronical nature of the treatment (P=.548), but 15.1% of the controlled respondents and 12.4% of uncontrolled respondents did not see the relation between the treatment and hypertension control (P=.525). 31.1% believed to be well-controlled, but in fact was not. CONCLUSIONS: Our patients doesn't know blood pressure targets of control. There isn't relationship between this knowledge and control of hypertension.

Estudio Conocimiento: grado de conocimiento sobre hipertensión arterial de nuestros pacientes. Relación con el nivel de control de la misma / Knowledge level of hypertensive patients about hypertension. Relationship between knowledge level and hypertension control

Objetivo: Evaluar el conocimiento de nuestros pacientes hipertensos sobre su HTA y su relación con el control de la misma. Material y métodos: Estudio descriptivo transversal con 400 hipertensos, mayores de edad, seleccionados de forma sistemática consecutiva de 50 consultas de atención primaria, que respondieron una encuesta sobre HTA. Las variables recogidas fueron los ítems de la encuesta, edad, sexo, nivel educacional, ocupación, cifras de presión arterial y tratamiento antihipertensivo. Las diferencias se analizaron con los test ji-cuadrado, Kruskal-Wallis, Wilcoxon, Anova y Bonferroni según distribución normal. Resultados: Fueron válidas 323 encuestas. El 52,9% fueron mujeres, edad media de 65,4años (DE: 11,2). El 54,8% contaban con estudios primarios. El 39,6% conocían los objetivos de control de PA sistólica, y solo el 19,6% los de PA diastólica, sin diferencias entre controlados y no controlados (PA sistólica: 39% vs 38,1%, p = 0,887; PA diastólica: 19,2% vs 21%, p = 0,721). Más del 70% conocían las modificaciones del estilo de vida, sin diferencias entre controlados y no controlados. El 82% de los controlados y el 79% de los no controlados reconocieron la cronicidad del tratamiento (p = 0,548), pero el 15,1% de los controlados y el 12,4% de los no controlados no lo relacionaban con el control de la HTA (p = 0,525). El 31,1% creían estar bien controlados aunque no lo estaban. Conclusiones: Los pacientes hipertensos conocen en baja frecuencia cuáles son los objetivos de control, sin encontrar relación entre el conocimiento del problema y el control del mismo

Objective: To assess the knowledge of the hypertensive patients about their hypertension and their relation to its control. Material and methods: Cross-sectional study among 400 hypertensive patients, all over 18 years, selected from 50 primary-care centres, who responded to an hypertension-related survey. Included variables were survey items, age, gender, educational level, professional occupation, blood pressure data and antihypertensive treatment. The obtained differences were analyzed using the chi-square test, Kruskal-Wallis, Wilcoxon, Anova and Bonferroni methods. Results: There were 323 valid surveys. 52.9% of respondents were women, the average age: 65.4 years (SD: 11.2), 54.8% of them had primary education. 39.6% were aware of the objectives of systolic BP control. Only 19.6% having knowledge of those for diastolic BP control, with no differences between controlled and uncontrolled (systolic BP: 39% vs 38.1%, P = .887; diastolic BP: 19.2% vs 21%, P = .721). Over 70% knew about lifestyle changes, without significant differences between controlled and uncontrolled respondents. 82% of controlled respondents, and 79% of those uncontrolled, recognized the chronical nature of the treatment (P = .548), but 15.1% of the controlled respondents and 12.4% of uncontrolled respondents did not see the relation between the treatment and hypertension control (P = .525). 31.1% believed to be well-controlled, but in fact was not. Conclusions: Our patients doesn’t know blood pressure targets of control. There isn’t relationship between this knowledge and control of hypertension

Validez de la automedida de la presión arterial en el diagnóstico de hipertensión arterial, hipertensión clínica aislada e hipertensión enmascarada / Validity of self-measurement of blood pressure in the diagnosis of high blood pressure, isolated hypertension and masked hypertension

Introducción y objetivosEl diagnóstico y control de la hipertensión arterial se sigue basando en la toma de presión arterial (PA) en consulta. Sin embargo, este procedimiento presenta limitaciones, por lo que se está generalizando en atención primaria el uso de la automedida de la presión arterial (AMPA). Nos planteamos estudiar la validez de esta técnica en el diagnóstico de hipertensión y en la detección de las situaciones de hipertensión clínica aislada e hipertensión enmascarada.MétodosEstudiamos 194 pacientes, con y sin diagnóstico previo de hipertensión. A todos ellos se les midió la PA en consulta, se les realizó una monitorización de la PA durante 48h y finalmente una AMPA en domicilio.ResultadosLa AMPA presenta una especificidad de 0,85 o 0,76 (dependiendo del parámetro de monitorización ambulatoria de la presión arterial considerado como patrón oro) en el diagnóstico de hipertensión, mayor que la que presenta la toma de PA en consulta (0,65/0,54). La sensibilidad de la AMPA (0,62/0,64) es menor que la de la toma de PA clínica (0,81/0,80).ResultadosLa AMPA tiene para el diagnóstico de hipertensión clínica aislada una moderada sensibilidad (0,75/0,64) y especificidad (0,65/0,68), un alto valor predictivo negativo (0,93/0,81), un bajo valor predictivo positivo (0,28/0,47) y unos pobres coeficientes de probabilidad (positivo: 2,32/2,01; negativo: 0,39/0,53).ResultadosLa AMPA tiene una alta especificidad (0,90/0,87), unos moderados valores predictivos (positivo: 0,75/0,63; negativo: 0,73/0,76) y un moderado coeficiente de probabilidad positivo (4,73/3,41) para el diagnóstico de hipertensión arterial enmascarada.ConclusionesLa AMPA es un complemento para el diagnóstico y seguimiento de nuestros pacientes en el primer nivel de la atención sanitaria, pero debemos ser cautos en lo que nos puede ofrecer (AU)

Introduction and objectivesDiagnosis and control of high blood pressure are still based on measuring blood pressure in the doctor's office. However, this procedure has limitations, so that the use of self-measurement of blood pressure is becoming generalized in primary care. We have proposed the study of the validity of this technique in the diagnosis of high blood pressure and in the detection of the situations of isolated and masked hypertension.MethodsWe studied 194 patients, with and without previous diagnosis of high blood pressure. Blood pressure was measured for all of them in the doctor's office and 48-hour monitoring of the blood pressure was performed. Finally self-measurement of blood pressure was done in the home.ResultsABPM showed a specificity of 0.85 or 0.76 (depending on the ABPM parameter considered as gold standard) in the diagnosis of high blood pressure. This was higher than that found when the blood pressure was obtained in the doctor's office (0.65/0.54). Sensitivity of the ABPM (0.62/0.64) is lower than when the BP is obtained in the doctor's office (0.81/0.80)ResultsABPM has a moderate sensitivity (0.75/0.64) and specificity (0.65/0.68), high negative predictive value (0.93/0.81), with low positive predictive value (0.28/0.47) and poor likelihood coefficients (PPC 2.32/2.01–NPC 0.39/0.53) for the diagnosis of isolated hypertension.ResultsABPM has high specificity (0.90/0.87), moderate predictive values (PPV 0.75/0.63, NPV 0.73/0.76) and moderate positive likelihood coefficient (4.73/3.41), for the diagnosis of masked hypertension.ConclusionsABPM is a complement to the diagnosis and follow-up of our patients in the first level of health care, but we should be cautious regarding what it can offer us (AU)

Revisión y valoración de 5 guías de manejo de la hipertensión arterial / Review and appraisal of 5 guidelines for managing hypertension

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