Sanchez Ramiro A, Ayala Miryam, Baglivo Hugo, Velazquez Carlos, Burlando Guillermo, Kohlmann Oswaldo, Jimenez Jorge, Jaramillo Patricio López, Brandao Ayrton, Valdes Gloria, Alcocer Luis, Bendersky Mario, Ramirez Agustín José, Zanchetti Alberto
Sección Hipertensión Arterial y Unidad Metabólica, Fundación Favaloro. Belgrano 1782 P: 4, Buenos Aires, Argentina.
J Hypertens. 2009 May;27(5):905-22. doi: 10.1097/HJH.0b013e32832aa6d2.
Hypertension is a highly prevalent cardiovascular risk factor in the world and particularly overwhelming in low and middle-income countries. Recent reports from the WHO and the World Bank highlight the importance of chronic diseases such as hypertension as an obstacle to the achievement of good health status. It must be added that for most low and middle-income countries, deficient strategies of primary healthcare are the major obstacles for blood pressure control. Furthermore, the epidemiology of hypertension and related diseases, healthcare resources and priorities, the socioeconomic status of the population vary considerably in different countries and in different regions of individual countries. Considering the low rates of blood pressure control achieved in Latin America and the benefits that can be expected from an improved control, it was decided to invite specialists from different Latin American countries to analyze the regional situation and to provide a consensus document on detection, evaluation and treatment of hypertension that may prove to be cost-utility adequate. The recommendations here included are the result of preparatory documents by invited experts and a subsequent very active debate by different discussion panels, held during a 2-day sessions in Asuncion, Paraguay, in May 2008. Finally, in order to improve clinical practice, the publication of the guidelines should be followed by implementation of effective interventions capable of overcoming barriers (cognitive, behavioral and affective) preventing attitude changes in both physicians and patients.
高血压是全球一种高度普遍的心血管危险因素，在低收入和中等收入国家尤为突出。世界卫生组织和世界银行最近的报告强调了高血压等慢性病作为实现良好健康状况的障碍的重要性。必须指出的是，对于大多数低收入和中等收入国家来说，初级医疗保健策略不足是血压控制的主要障碍。此外，高血压及相关疾病的流行病学、医疗资源和重点、不同国家以及单个国家不同地区的人口社会经济状况差异很大。考虑到拉丁美洲实现的血压控制率较低以及改善控制可能带来的益处，决定邀请来自不同拉丁美洲国家的专家分析该地区情况，并提供一份关于高血压检测、评估和治疗的共识文件，该文件可能证明在成本效益方面是合适的。这里包含的建议是受邀专家编写的预备文件以及不同讨论小组随后在2008年5月于巴拉圭亚松森举行为期两天的会议期间进行的非常活跃的辩论的结果。最后，为了改善临床实践，在发布指南之后应实施有效的干预措施，以克服阻碍医生和患者态度转变的障碍（认知、行为和情感方面）。
