Amorim Kecia C F O, Vitorino Priscila Valverde O, Feitosa Audes D M, Santos Mayara Cedrim, Bezerra Rodrigo, Lopes Lais Rocha, Camafort Miguel, Coca Antonio, Sousa Ana Luíza Lima, Barroso Weimar K S
Pós Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, Brasil.
Programa de Pós-graduação Stricto Sensu em Atenção à Saúde, Escola de Ciências Sociais e da Saúde, Pontifícia Universidade Católica de Goiás, Goiânia, Brasil.
Front Cardiovasc Med. 2023 Sep 18;10:1254933. doi: 10.3389/fcvm.2023.1254933. eCollection 2023.
Hypertension (HT) remains the leading cause of death worldwide. In Brazil it is estimated that 35% of the adult population has HT and that about 20% of these have blood pressure values within the targets recommended for the reduction of cardiovascular risk. There are some data that point to different control rates in patients treated by cardiologists in public and private referral center and this is an important point to be investigated and discussed.
To compare sociodemographic characteristics, body mass index (BMI), antihypertensive (AH) drugs, blood pressure (BP) and control rate in public (PURC) and private (PRRC) referral centers.
A cross-sectional multicenter study that analyzed data from hypertensive patients assisted by the PURC (one in Midwest Region and other in Northeast region) and PRRC (same distribution). Variables analyzed: sex, age, BMI, classes, number of AH used and mean values of systolic and diastolic BP by office measurement and home blood pressure measurement (HBPM). Uncontrolled hypertension (HT) phenotypes and BP control rates were assessed. Descriptive statistics and tests or unpaired -tests were performed. A significance level of < 0.05 was considered.
A predominantly female (58.9%) sample of 2.956 patients and a higher prevalence of obesity in PURC ( < 0.001) and overweight in PRRC ( < 0.001). The mean AH used was 2.9 ± 1.5 for PURC and 1.4 ± 0.7 for PRRC ( < 0.001). Mean systolic and diastolic BP values were higher in PURC as were rates of uncontrolled HT of 67.8% and 47.6% ( < 0.001) by office measurement and 60.4% and 35.3% ( < 0.001) by HBPM in PURC and PRRC, respectively.
Patients with HT had a higher prevalence of obesity in the PURC and used almost twice as many AH drugs. BP control rates are worse in the PURC, on average 15.3 mmHg and 12.1 mmHg higher than in the PRRC by office measurement.
高血压仍然是全球主要的死亡原因。据估计，巴西35%的成年人口患有高血压，其中约20%的人的血压值处于为降低心血管风险而推荐的目标范围内。有一些数据表明，在公立和私立转诊中心接受心脏病专家治疗的患者中，血压控制率有所不同，这是一个需要调查和讨论的重要问题。
比较公立（PURC）和私立（PRRC）转诊中心患者的社会人口学特征、体重指数（BMI）、抗高血压（AH）药物、血压（BP）及控制率。
一项横断面多中心研究，分析了由PURC（一个位于中西部地区，另一个位于东北地区）和PRRC（相同分布）诊治的高血压患者的数据。分析的变量包括：性别、年龄、BMI、类别、使用的AH药物数量以及通过诊室测量和家庭血压测量（HBPM）得出的收缩压和舒张压平均值。评估未控制高血压（HT）的表型和血压控制率。进行描述性统计以及检验或非配对检验。显著性水平设定为<0.05。
2956名患者组成的样本中女性占主导（58.9%），PURC中肥胖患病率更高（<0.001），PRRC中超重患病率更高（<0.001）。PURC平均使用AH药物2.9±1.5种，PRRC为1.4±0.7种（<0.001）。PURC的收缩压和舒张压平均值更高，通过诊室测量，PURC未控制高血压的比例分别为67.8%和47.6%（<0.001），通过HBPM测量，PURC和PRRC中未控制高血压的比例分别为60.4%和35.3%（<0.001）。
高血压患者中，PURC的肥胖患病率更高，使用的AH药物数量几乎是PRRC的两倍。PURC的血压控制率更差，通过诊室测量，平均比PRRC分别高15.3 mmHg和12.1 mmHg。
