Hypertension Program, Hospital de Clínicas, Universidad de Buenos Aires, Buenos Aires, Argentina.
Am J Ther. 2010 May-Jun;17(3):295-300. doi: 10.1097/MJT.0b013e3181bdc3f6.
The objectives of this cross-sectional study were to determine awareness degree, treatment status, and control of hypertension and its predictors in a consecutive group of attendees at a Buenos Aires University School Hospital primary care setting from April 2003 to May 2006. Results for 1733 hypertensive subjects, all of them white (578 men and 1155 women), were available for analyses. Mean age of hypertensive subjects was 66.61 +/- 12.34 years. Eighty-seven percent of hypertensive patients knew their diagnosis. Prevalence of hypertension was consistently higher in overweight-obese than in normal weight subjects (P < 0.001). Overall prevalence of hypertension treatment was 62%, and blood pressure (BP) control rate was 30%. Among knowledgeable treated hypertensive patients, 80.4% used only one antihypertensive drug, 17.6% used two, and 2% used three (P < 0.001). Only 8% of hypertensive patients carried out consensus-recommended dietarian guidelines. A prevention index performed with periodic general prevention measures during the past 5 years was calculated. Logistic regression model showed that independent variables more likely to be associated with poor BP control were being overweight (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.057-2.208), obesity (OR 2.1, 95% CI 1.307-3.286), and previous stroke (OR 2.9, 95% CI 1.099-7.652). Conversely, the higher the prevention index, the less odds of uncontrolled BP (OR 0.841, 95% CI 0.725-0.975). These results highlight the consistency of general primary care prevention measures with achieving BP control. The poor control rates of BP found in patients who already suffered from stroke suggest that, after hospital discharge for that event, antihypertensive therapy was inadequate and document the challenge that these situations impose on primary care physicians.
本横断面研究的目的是确定 2003 年 4 月至 2006 年 5 月在布宜诺斯艾利斯大学附属医院初级保健机构连续就诊的一组患者中高血压的知晓率、治疗状况和控制情况及其预测因素。共分析了 1733 例高血压患者（578 名男性和 1155 名女性）的结果。高血压患者的平均年龄为 66.61±12.34 岁。87%的高血压患者知道自己的诊断。超重肥胖患者的高血压患病率始终高于正常体重患者（P<0.001）。高血压治疗的总体患病率为 62%，血压控制率为 30%。在知晓并接受治疗的高血压患者中，80.4%仅使用一种降压药，17.6%使用两种，2%使用三种（P<0.001）。只有 8%的高血压患者遵循了共识推荐的饮食指南。根据过去 5 年中定期进行的一般预防措施，计算了预防指数。Logistic 回归模型显示，与血压控制不良更相关的独立变量是超重（比值比 [OR] 1.53，95%置信区间 [CI] 1.057-2.208）、肥胖（OR 2.1，95% CI 1.307-3.286）和既往脑卒中（OR 2.9，95% CI 1.099-7.652）。相反，预防指数越高，血压不受控制的可能性越低（OR 0.841，95% CI 0.725-0.975）。这些结果突出了一般初级保健预防措施与实现血压控制之间的一致性。已经患有中风的患者中血压控制不佳的比例表明，在因该事件出院后，抗高血压治疗可能不足，这反映了这些情况对初级保健医生的挑战。
