[Prevention of therapeutic inertia in the treatment of arterial hypertension by using a program of home blood pressure monitoring].

OBJECTIVE

To evaluate the efficacy of a program of home blood pressure monitoring (HBPM) on therapeutic Inertia (TI) in mild-to-moderate hypertension (AHT).

DESIGN

Controlled, randomised clinical trial.

SETTING

Forty six clinics in 35 primary care centres. Spain.

PARTICIPANTS

A total of 232 patients with uncontrolled hypertension were included.

INTERVENTION

Two groups with 116 patients were formed: 1) Control group (CG): standard health intervention; 2) Intervention group (IG): patients who were included in the HBPM program.

MAIN MEASUREMENTS

TI was calculated by the ratio: Number of patients whose pharmacological treatment was not changed in each visit/Number of patients with an average BP 140mmHg and/or 90mmHg in the general population or 130 and/or 90 mmHg in diabetics. The mean BPs and the percentage of controlled patients were calculated. The mean number of people that required an intervention in order to avoid TI was calculated (NI).

RESULTS

A total of 209 patients completed the study, with TI in 35.64% (95% CI=29.85%-41.43%) of the sample, and in 71.63% (95% CI=63.9-79.36%) of the uncontrolled hypertensive patients. The TI was 22.42% (95% CI=24.2-37%) in the IG and 50% (95% CI=37.75-62.25) in the CG (p<.05) in visit 2, and 25.23% (95% CI=14.84-35.62) and 46.07% (95% CI=33.85-58.29) in the final visit for IG and CG, respectively (P<.05). The NI was 4.3.

CONCLUSIONS

TI was very significant among the uncontrolled hypertensive patients. The studied interventions are effective for improving TI.