Araujo Jairo Carneiro de, Guimarães Armênio Costa
Fundação Bahiana para o Desenvolvimento das Ciências, Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil.
Rev Saude Publica. 2007 Jun;41(3):368-74. doi: 10.1590/s0034-89102007000300007.
To assess the impact of the implementation of the Family Health Care Program for arterial hypertension management in a primary care unit.
There were studied 135 patients with confirmed diagnosis of arterial hypertension (45 patients from each primary care team) who received treatment between December 2003 and December 2004 and were followed up until July 2005 in the city Salvador, Northeastern Brazil. Blood pressure measures were compared at baseline and at the end of the follow-up period, and their association with cardiovascular risk factors and variables such as gender, age, body mass index, number of medical visits, number of antihypertensive drugs taken by patients, education level and family income were evaluated. Data were described as means and standard deviations, absolute and percentual values and the Wilcoxon, Kruskal-Walis and Chi-square tests were performed.
Mean blood pressures at baseline and at the end of the follow-up were 155.9+/-24.1/95.3+/-13.9 mmHg and 137.2+/-16.1/86.7+/-8.7 mmHg (p<0.01), respectively. At starting treatment, 28.9% hypertense patients had well-controlled blood pressure levels (<140/90 mmHg) compared to 57% at the end of the follow-up period (p<0.01). The mean number of medical visits was 10.1+/-3.9, with 91.8% compliance. Two antihypertensive drugs were used by 50.4% and one drug by 35.6% of the patients. The prevalences of associated risk factors assessed at entering the program were overweight/obesity (71.9%), dyslipidemia (58.5%) and diabetes/impaired fasting glucose (43.7%). The results of the different care teams were comparable.
The implementation of the Family Health Care Program has provided a better management of arterial hypertension but the associated risk factors have remained at higher levels than those recommended and thus needing better management.
评估在初级保健机构实施家庭保健计划对动脉高血压管理的影响。
对巴西东北部萨尔瓦多市135例确诊为动脉高血压的患者（每个初级保健团队45例）进行研究，这些患者于2003年12月至2004年12月接受治疗，并随访至2005年7月。比较基线和随访期末的血压测量值，并评估其与心血管危险因素以及性别、年龄、体重指数、就诊次数、患者服用的抗高血压药物数量、教育水平和家庭收入等变量的关联。数据以均值和标准差、绝对值和百分比值表示，并进行Wilcoxon、Kruskal-Walis和卡方检验。
基线和随访期末的平均血压分别为155.9±24.1/95.3±13.9 mmHg和137.2±16.1/86.7±8.7 mmHg（p<0.01）。开始治疗时，28.9%的高血压患者血压控制良好（<140/90 mmHg），而随访期末这一比例为57%（p<0.01）。平均就诊次数为10.1±3.9次，依从率为91.8%。50.4%的患者使用两种抗高血压药物，35.6%的患者使用一种药物。纳入该计划时评估的相关危险因素患病率分别为超重/肥胖（71.9%）、血脂异常（58.5%）和糖尿病/空腹血糖受损（43.7%）。不同保健团队的结果具有可比性。
家庭保健计划的实施对动脉高血压进行了更好的管理，但相关危险因素仍高于推荐水平，因此需要更好的管理。
