Identifying masked uncontrolled hypertension in the community pharmacy setting

Sabater‐Hernández, Daniel; Sendra-Lillo, José; Jiménez-Monleón, Jose J.; Benrimoj, Shalom I.; Durks, Desire; Martínez-Mart́inez, Fernando; Sierra, Alejandro de la

doi:10.1097/mbp.0000000000000105

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…23,24 Pharmacy-based blood pressure measurement has been used to identify patients with hypertension, and pharmacist screening can identify atrial fibrillation in high-risk patients. 25,26 Additionally, new point-of-care tests have been used to identify specific infectious diseases, including viral hepatitis and HIV infection. [27][28][29][30] Spirometry testing aids in recognizing and managing asthma and chronic obstructive pulmonary disease.…”

Section: The New Competencies For Diagnosis Align With the Existing Pmentioning

confidence: 99%

Pharmacy Education Needs to Address Diagnostic Safety

Graber

Grice

Ling

et al. 2019

American Journal of Pharmaceutical Education

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The American Association of Colleges of Pharmacy, the Accreditation Council for Pharmacy Education, and the Center for the Advancement of Pharmacy Education frame patient safety from the perspective of medication management, which is also the current focus of pharmacy education and training. With the growing appreciation that diagnostic errors represent an urgent and actionable patient safety concern, the National Academy of Medicine has recommended diagnostic safety training for all health care professions. The Society to Improve Diagnosis in Medicine has worked with an interprofessional consensus group to identify a set of 12 key competencies necessary to achieve diagnostic quality and safety that focuses on individual, team-based, and system-related competencies. Much of this already exists in pharmacy education, but pharmacy training programs need to give graduates more guidance on how they contribute to the diagnostic process and the prevention and detection of diagnostic errors. We describe the current state of progress in this regard, and what steps are needed by training programs to provide content and assessment so that graduates achieve the requisite competencies. Governing and advisory bodies need to expand the expectations around patient safety to include diagnostic safety.

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Section: The New Competencies For Diagnosis Align With the Existing Pmentioning

confidence: 99%

Pharmacy Education Needs to Address Diagnostic Safety

Graber

Grice

Ling

et al. 2019

American Journal of Pharmaceutical Education

View full text Add to dashboard Cite

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“…Tiene una prevalencia que ronda el 20% en la población general [18,19] y el 45% en ancianos [20,21]. Permite detectar también la hipertensión enmascarada no controlada, definida como la presencia en pacientes con tratamiento antihipertensivo de mediciones en consulta de presión arterial sistólica y diastólica inferiores a 140/90 mmHg pero con registros MAPA en los que la presión arterial es igual o superior a 135/85 mmHg durante la actividad y/o igual o superior a 120/70 mmHg durante el sueño, y/o una media de presión arterial de 24 horas igual o superior a 130/80 mmHg, que tiene una prevalencia que se sitúa en el 13% en estudios poblacionales [21,22].…”

Section: Introductionunclassified

“…El farmacéutico comunitario, en equipo interdisciplinar con el médi-co de atención primaria, ocupa un lugar privilegiado en el cribado de la hipertensión mediante estrategia oportunista a través de la medición periódica de la presión arterial de los usuarios [22][23][24][25].…”

Section: Introductionunclassified

Proyecto ‘KAIRÓS’: monitorización ambulatoria de la presión arterial en farmacia comunitaria. Control y seguimiento de la presión arterial en pacientes hipertensos ancianos tratados

Álvarez¹,

Cores²,

Fernández³

et al. 2018

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Objetivos: Conocer, mediante la monitorización ambulatoria de la presión arterial (MAPA) en farmacia comunitaria (FC), el grado de control de la presión arterial (PA) del paciente hipertenso anciano. Identificación del perfil circadiano. Identificación de hipertensión clínica aislada (HCA) e hipertensión enmascarada no controlada (HENC). Métodos: Muestreo consecutivo de los pacientes hipertensos ancianos con tratamiento farmacológico antihipertensivo atendidos en dos FC. Se realizó medida aislada de presión arterial en farmacia comunitaria (MAFC) y MAPA durante un mínimo de 29h a cada paciente. Se envió informe al médico para su valoración. Resultados: 219 pacientes (47,9% mujeres, edad media 71,5±5,4 años). El grado de control con medida con MAFC (74 pacientes) es del 34% y con MAPA (99 pacientes) es del 45%. La prevalencia de patrón circadiano dipper fue del 29,7%. 21 pacientes hipertensos controlados con MAFC (<140/90) (9,6%) tuvieron cifras de PA≥130/80 en MAPA 24h y/o ≥135/85 en MAPA actividad y/o ≥120/70 MAPA nocturna, considerándose pacientes con hipertensión enmascarada no controlada (HENC). 46 pacientes hipertensos no controlados en MAFC (≥140/90) (21%) tuvieron cifras de PA<130/80 en MAPA 24h y <135/85 en MAPA actividad y <120/70 MAPA nocturna, considerándose pacientes con hipertensión clínica aislada (HCA). Conclusiones: El grado de control de la PA de pacientes hipertensos ancianos es mayor cuando se analiza mediante MAPA. Su perfil circadiano es mayoritariamente non dipper. La realización de MAPA en FC permite identificar la HCA y la HENC. La medida aislada de PA es insuficiente para optimizar el control de la HTA en estos pacientes. 'KAIRÓS' project: ambulatory monitoring of blood pressure in community pharmacies. Monitoring and follow-up of blood pressure in hypertensive elderly patients under treatment ABSTRACT Objectives: Learning, through ambulatory blood pressure monitoring (AMBP) in community pharmacies (CP), the level of blood pressure (BP) monitoring in hypertensive elderly patients. Identification of circadian profile. Identification of isolated clinical hypertension (ICH) and hidden uncontrolled hypertension (HUH). PALABRAS CLAVE Monitorización ambulatoria de la presión arterial, ancianos, servicios profesionales farmacéuticos, farmacia comunitaria, hipertensión clínica aislada, hipertensión enmascarada, ritmo circadiano Financiación: ninguna. Conflicto de intereses: ninguno. Contribución a la autoría: OPA, BVC, JCRF y MIBG contribuyeron por igual al diseño del estudio, el desarrollo de la investigación, el análisis de los resultados, su tratamiento estadístico, la redacción del manuscrito y la revisión del contenido final. LBG contribuyó al análisis de los resultados, el tratamiento estadístico y la revisión del contenido final..

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Masked uncontrolled hypertension in patients on maintenance hemodialysis

et al. 2017

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Masked uncontrolled hypertension (MUCH) has been proven to be associated with increased cardiovascular risk in the general population. We performed the current analysis to determine its prevalence in dialysis patients and its association with pulse wave velocity (PWV). From 368 participants of another cohort study, we selected 145 subjects with controlled predialysis blood pressure (BP). All subjects underwent ambulatory BP monitoring and PWV measurement. MUCH was defined as controlled predialysis BP with daytime BP⩾135/85 mm Hg (definition-1); total ambulatory BP⩾130/80 mm Hg (definition-2); and either daytime BP⩾135/85 mm Hg or nighttime BP⩾120/70 mm Hg (definition-3). The prevalence of MUCH was 43.4% (definition-1), 55.9% (definition-2) and 74.5% (definition-3). Multivariable logistic regression analysis showed that the use of antihypertensive medication was the most consistent predictor of MUCH within all 3 definitions (all odds ratio (OR)⩾4.28, P<0.001). Predialysis systolic BP (both OR>1, P⩽0.04), predialysis diastolic BP (both OR>1, P⩽0.001) and hemoglobin (both OR<1, P=0.02) were all significantly associated with MUCH in two models. Interdialytic weight gain (OR=0.52, P=0.02) was associated with MUCH under definition-2, and BMI (OR=0.86, P=0.03) was associated with MUCH under definition-3. Patients with MUCH had significantly elevated PWV compared with their counterparts according to all three definitions with or without adjusting for covariates (all P⩽0.03). In conclusion, MUCH affects a large proportion of dialysis patients with controlled predialysis BP and is associated with increased PWV. Patients on antihypertensive medications and with higher predialysis BP are more likely to have MUCH.

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Identifying masked uncontrolled hypertension in the community pharmacy setting

Cited by 3 publications

References 25 publications

Pharmacy Education Needs to Address Diagnostic Safety

Pharmacy Education Needs to Address Diagnostic Safety

Proyecto ‘KAIRÓS’: monitorización ambulatoria de la presión arterial en farmacia comunitaria. Control y seguimiento de la presión arterial en pacientes hipertensos ancianos tratados

Masked uncontrolled hypertension in patients on maintenance hemodialysis

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