Márquez Contreras Emilio, Martín de Pablos José Luis, Espinosa García Jacinto, Casado Martínez José Joaquín, Sanchez López Eugenio, Escribano José
Unidad de Gestión Clínica La Orden, Huelva, España.
Aten Primaria. 2012 Feb;44(2):89-96. doi: 10.1016/j.aprim.2010.09.022. Epub 2011 Oct 20.
To evaluate the efficacy of a program of home blood pressure monitoring (HBPM) on therapeutic Inertia (TI) in mild-to-moderate hypertension (AHT).
Controlled, randomised clinical trial.
Forty six clinics in 35 primary care centres. Spain.
A total of 232 patients with uncontrolled hypertension were included.
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.
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).
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.
TI was very significant among the uncontrolled hypertensive patients. The studied interventions are effective for improving TI.
评估家庭血压监测（HBPM）方案对轻度至中度高血压（AHT）治疗惰性（TI）的疗效。
对照随机临床试验。
西班牙35个初级保健中心的46家诊所。
共纳入232例未控制高血压患者。
将患者分为两组，每组116例：1）对照组（CG）：标准健康干预；2）干预组（IG）：纳入HBPM方案的患者。
TI通过以下比率计算：每次就诊时药物治疗未改变的患者人数/一般人群中平均血压≥140mmHg和/或90mmHg或糖尿病患者中平均血压≥130mmHg和/或90mmHg的患者人数。计算平均血压和血压控制患者的百分比。计算为避免TI所需的平均干预人数（NI）。
共209例患者完成研究，样本中TI为35.64%（95%CI = 29.85% - 41.43%），未控制高血压患者中TI为71.63%（95%CI = 63.9 - 79.36%）。在第2次就诊时，IG组的TI为22.42%（95%CI = 24.2 - 37%），CG组为50%（95%CI = 37.75 - 62.25）（p <.05）；在最后一次就诊时，IG组和CG组分别为25.23%（95%CI = 14.84 - 35.62）和46.07%（95%CI = 33.85 - 58.29）（P <.05）。NI为4.3。
TI在未控制高血压患者中非常显著。所研究的干预措施对改善TI有效。
