Control de la presión arterial en la población hipertensa española atendida en atención primaria. Estudio PRESCAP 2006

Llisterri, J.L.; Roca, G.C. Rodríguez; Moreno, F.J. Alonso; Arnal, Salvador Lou; Garrote, J.A. Divisón; Rodríguez, J.A. Santos; Béjar, Anna Raber; Sansó, Rous de Castellar; Urioste, L.M. Ruilope; Banegas, José R.

doi:10.1157/13120766

Cited by 151 publications

(27 citation statements)

References 18 publications

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“…This conveys a reassuring message to practicing physicians, inasmuch as they are doing better in BP control than is believed on the basis of office-or population-based surveys, especially in Europe. 2,3,22 Although the effectiveness of BP control does not exclusively depend on physicians, professional practices are at least as responsible as patient-related factors if not more so. 3 …”

Section: Discussionmentioning

confidence: 99%

“…This suggests that antihypertensive drugs were not at their peak antihypertensive effect when BP was determined in the morning, and consideration should also be given to the fact that many drugs do not encompass a full 24-hour period. 2,25,26 Likewise, taking antihypertensive drugs solely in the morning (versus taking them twice per day) was associated with a higher probability of office resistance and underestimation of BP control. This may be partially because of the fact that most BP determinations occurred in the morning.…”

Section: Predictors Of Disagreement Between Clinical Bp Control and Amentioning

confidence: 99%

“…[1][2][3] However, physicians frequently misclassify patients' blood pressure (BP) status at the office when compared with ambulatory BP monitoring (ABPM). 4 In particular, BP readings are higher in standard clinical practice than in ambulatory readings.…”

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confidence: 99%

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Effectiveness of Blood Pressure Control Outside the Medical Setting

Banegas¹,

Segura²,

Sobrino³

et al. 2007

Hypertension

169

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Abstract-We studied the effectiveness of blood pressure (BP) control outside the clinic by using ambulatory BP monitoring (ABPM) among a large number of hypertensive subjects treated in primary care centers across Spain. The sample consisted of 12 897 treated hypertensive subjects who had indications for ABPM. Office-based BP was calculated as the average of 2 readings. Twenty-four-hour ABPM was then performed using a SpaceLabs 90207 monitor under standardized conditions. A total of 3047 patients (23.6%) had their office BP controlled, and 6657 (51.6%) were controlled according to daytime ABPM. The proportion of office resistance or underestimation of patients' BP control by physicians in the office (office BP Ն140/90 mm Hg and average daytime ambulatory BP Ͻ135/85 mm Hg) was 33.4%, and the proportion of isolated office control or overestimation of control (office BP Ͻ140/90 mm Hg and average daytime ambulatory BP Ն135/85 mm Hg) was 5.4%. BP control was more frequently underestimated in patients who were older, female, obese, or with morning BP determination than in their counterparts. BP control was more frequently overestimated in those who were younger, male, nonobese, smokers, or with evening BP determination. Ambulatory-based hypertension control was far better than office-based hypertension control. This conveys an encouraging message to clinicians, namely that they are actually doing better than is evidenced by office-based data. However, the burden of underestimation and overestimation of BP control at the office is still remarkable. Physicians should be aware that the likelihood of misestimating BP control is higher in some hypertensive subjects. Key Words: office blood pressure Ⅲ ambulatory blood pressure Ⅲ treatment goals Ⅲ guidelines Ⅲ control A dequate control of hypertension is low in population and medical settings. 1-3 However, physicians frequently misclassify patients' blood pressure (BP) status at the office when compared with ambulatory BP monitoring (ABPM). 4 In particular, BP readings are higher in standard clinical practice than in ambulatory readings. 4,5 Nevertheless, the magnitude of the gap between office and ambulatory BP control has not been noted in large-scale studies addressing daily practice.Furthermore, the prevalence and determinants of BP conditions, such as white-coat hypertension ([WCH] ie, high office BP with normal BP outside the medical setting) and masked hypertension (normal office BP with high BP outside the medical setting) have already been studied. 6 -14 However, WCH is a term reserved for those subjects not on antihypertensive treatment 6 ; and in the case of treated hypertensive subjects, it would, therefore, be more accurate to use the term "office resistance," 6 that is, in-clinic BP readings that are both higher than goal despite treatment and higher than normotensive BP outside the clinic as demonstrated by ABPM. Likewise, we focused on "isolated office control" (BP controlled at the office but uncontrolled on ABPM despite treatment) rather than masked hyper...

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Section: Discussionmentioning

confidence: 99%

Section: Predictors Of Disagreement Between Clinical Bp Control and Amentioning

confidence: 99%

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Effectiveness of Blood Pressure Control Outside the Medical Setting

Banegas¹,

Segura²,

Sobrino³

et al. 2007

Hypertension

169

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show abstract

“…Estos datos son preocupantes dada la mayor morbimortalidad de la HTA a partir de los 50 años con presiones sistólicas superiores a 140 mmHg 9 . Respecto al control de la PA de manera global en los pacientes en los que tenemos registradas las cifras de tensión arterial nuestro estudio refleja unas cifras de control en el 2003 del 45,1% y en el 2006 del 40,4%, superiores a las que refleja PRESCAP 25 (36,1% con buen control) o Controlpress (38,8%) 26 , y un estudio reciente en EEUU (36,8%) 27 . En algunas unidades especializadas de hipertensión y algunos centros de atención primaria el control es mejor 13,14,23 .…”

Section: Discussionunclassified

Efectividad de la atención primaria de salud en el diagnóstico y tratamiento de la hipertensión arterial

Brugos

Guillén

Díez

et al. 2008

Anales Sis San Navarra

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“…Nuestro estudio tiene la ventaja de tener resultados que se podrían inferir a la población general por el cálculo representativo y muestreo aleatorio. Analizando el riesgo CV global poblacional observamos una disminución en el tiempo, lo que probablemente tenga que ver con un mejor control de los diferentes factores de riesgo (hipertensión arterial, diabetes mellitus e hipercolesterolemia), aspecto que se está observando en estudios realizados en los últimos años en nuestro país [27][28][29][30] , y con una disminución de la prevalencia del tabaquismo. En este sentido, también pudo influir la intervención mínima que se hizo en el primer corte (informe sobre riesgo individual y cómo mejorarlo que se enviaba al propio paciente a su domicilio para entregárselo a su médico de familia).…”

Section: Discusionunclassified