[Is the action taken by Catalonian primary care doctors adequate in view of the insufficient reduction in blood pressure levels in hypertensive patients? DISEHTAC-2001 study]. / Es adecuada la actitud que adoptan los médicos de atención primaria en Cataluña ante la insuficiente reducción de cifras de presión arterial en los pacientes hipertensos? Estudio DISEHTAC-2001.

OBJECTIVE: To determine the attitude to therapy of primary care staff in view of the lack of reduction in blood pressure. To describe the most commonly used antihypertensives. DESIGN: Descriptive, longitudinal, retrospective study during the year 2001. SETTING: Primary care, Spain. PARTICIPANTS: We analysed 990 hypertensive patients from 12 health centres picked from the 31 participants in the DISEHTAC-1996 study. METHODS: Age, sex, weight, and height were analysed, along with blood pressure values throughout the year 2001, therapeutic attitude (increase/replacement/combination) with poor control (more than 2 consecutive visits with blood pressure>139 and/or 89 mm Hg), screening and prevalence of cardiovascular risk factors (CVRF), and drugs used. RESULTS: There were 58.9% females; mean age: 65.4 (13.01) years, and 43.8% received 2 or more antihypertensives. The most common antihypertensives prescribed were diuretics (47.6%), and angiotensin-converting enzyme (ACE) inhibitors plus diuretics was the most used combination (22.1%). When there was poor control, some change in treatment was made in 76.8% (95% confidence interval [CI], 73.6-80) of cases. The most common was a combination of drugs (49.6%). The expected action was more frequent in those over 65 years and with a grade I of arterial hypertension (systolic blood pressure [SBP] between 140-150 and diastolic blood pressure [DBP] between 90-99 mm Hg (P<.001). CONCLUSIONS: Combined therapy is used in almost half of hypertensive patients, with the most common action being a drug combination.

¿Es adecuada la actitud que adoptan los médicos de atención primaria en Cataluña ante la insuficiente reducción de cifras de presión arterial en los pacientes hipertensos? Estudio DISEHTAC-2001 / Is the action taken by catalonian primary care doctors adequate in view of the insufficient reduction in blood pressure levels in hypertensive patients? DISEHTAC-2001 study

Objetivo. Determinar la actitud terapéutica delos profesionales de atención primaria antela falta de reducción de la presión arterial.Describir los tratamientos antihipertensivosmás utilizados.Diseño. Estudio descriptivo, longitudinaly retrospectivo llevado a cabo duranteel año 2001.Emplazamiento. Atención primaria.Participantes. Se incluyó a 990 pacienteshipertensos pertenecientes a 12 centros desalud, escogidos entre los 31 participantesen el estudio DISEHTAC-1996.Métodos. Se analizaron: edad, sexo, peso ytalla; valores de presión arterial recogidosdurante todo el año 2001; actitud terapéutica(aumento/sustitución/combinación) ante elmal control (más de 2 visitas consecutivascon presión arterial > 139 y/o 89 mmHg);cribado y prevalencia de factores de riesgocardiovascular (FRCV), y fármacosutilizados.Resultados. El 58,9% de los pacientesincluidos eran mujeres, con una edad mediade 65,4 ± 13,01 años. El 43,8% recibía 2 omás antihipertensivos. Los más prescritosfueron los diuréticos (47,6%) y lacombinación más usada fue la de uninhibidor de la enzima conversiva de laangiotensina (IECA) más un diurético(22,1%). Ante cifras de mal control, en el76,8% de los casos (intervalo de confianza[IC] del 95%, 73,6-80) se realizó algúncambio en el tratamiento, con frecuencia, seutilizó la combinación de fármacos (49,6%).La actitud expectante fue más frecuenteen los pacientes con edades ≥ 65 añosy con hipertensión arterial (HTA) de grado I(presión arterial sistólica [PAS] comprendidaentre 140 y 150 mmHg y presión arterialdiastólica [PAD] comprendida entre 90y 99 mmHg (p < 0,001).Conclusiones. La terapia combinada se utilizaen casi la mitad de los pacientes hipertensos.Es destacable la actitud activa de los médicosante la detección de reiterados controles depresión arterial elevados, y la actitud másfrecuente es la combinación de fármacos

Objective. To determine the attitudeto therapy of primary care staff in viewof the lack of reduction in blood pressure.To describe the most commonly usedantihypertensives.Design. Descriptive, longitudinal,retrospective study during the year 2001.Setting. Primary care, Spain.Participants.We analysed 990 hypertensivepatients from 12 health centres picked fromthe 31 participants in the DISEHTAC-1996 study.Methods. Age, sex, weight, and height wereanalysed, along with blood pressure valuesthroughout the year 2001, therapeuticattitude (increase/replacement/combination)with poor control (more than 2 consecutivevisits with blood pressure >139 and/or89 mm Hg), screening and prevalenceof cardiovascular risk factors (CVRF),and drugs used.Results. There were 58.9% females; meanage: 65.4 (13.01) years, and 43.8% received2 or more antihypertensives. The mostcommon antihypertensives prescribedwere diuretics (47.6%), and angiotensinconvertingenzyme (ACE) inhibitors plusdiuretics was the most used combination(22.1%).When there was poor control, somechange in treatment was made in 76.8%(95% confidence interval [CI], 73.6-80) ofcases. The most common was a combinationof drugs (49.6%). The expected action wasmore frequent in those over 65 years andwith a grade I of arterial hypertension(systolic blood pressure [SBP] between140-150 and diastolic blood pressure [DBP]between 90-99 mm Hg (P<.001).Conclusions. Combined therapy is used inalmost half of hypertensive patients, withthe most common action being a drugcombination