2021 Spanish Society of Hypertension position statement about telemedicine

SEA 2024 Standards for Global Control of Vascular Risk

One of the objectives of the Spanish Society of Arteriosclerosis is to contribute to the knowledge, prevention and treatment of vascular diseases, which are the leading cause of death in Spain and entail a high degree of disability and health expenditure. Atherosclerosis is a multifactorial disease and its prevention requires a global approach that takes into account the associated risk factors. This document summarises the current evidence and includes recommendations for patients with established vascular disease or at high vascular risk: it reviews the symptoms and signs to evaluate, the laboratory and imaging procedures to request routinely or in special situations, and includes the estimation of vascular risk, diagnostic criteria for entities that are vascular risk factors, and general and specific recommendations for their treatment. Finally, it presents aspects that are not usually referenced in the literature, such as the organisation of a vascular risk consultation.

Recommendations for the care of patients with cardiovascular disease in health emergency situations: a call to action

COVID-19 has had a negative impact on the health care of patients with cardiovascular disease and patients at high risk of cardiovascular disease. The restrictions affecting access to the health care system have conditioned the care received, resulting in poorer control and a higher risk of events. Taking action to improve the care provided during health emergencies is mandatory. It is important to promote the development of telemedicine and patient empowerment by fostering health literacy and a higher degree of self-care. In addition, primary care and coordination between health care levels should be improved. Moreover, the simplification and optimization of treatment, for example, using the cardiovascular polypill, have led to an improvement in adherence, better control of vascular risk factors, and a reduced risk of events. The present document provides specific recommendations for improving the care provided to patients under a health emergency.

[Optimizing blood pressure control through telemedicine in Primary Care in Spain (Iniciativa Óptima): Results from a Delphi study]

Objetivo

Representantes de los grupos de trabajo de hipertensión o enfermedad cardiovascular de las Sociedades Españolas de Médicos de Atención Primaria (MAP) [SEMERGEN], de Medicina Familiar y Comunitaria [semFYC] y de Médicos Generales y de Familia [SEMG] realizaron un estudio Delphi para validar con un panel de MAP expertos en hipertensión una propuesta de recomendaciones para optimizar la teleconsulta en pacientes hipertensos.

Materiales y métodos

Estudio Delphi basado en un cuestionario online con 59 recomendaciones, elaborado en base a la bibliografía relacionada disponible y a la experiencia clínica aportada por los autores.

Resultados

Un total de 118 MAP participaron en dos rondas del cuestionario (98,3% de los invitados), alcanzándose el consenso en 53/62 sentencias (85%). El equipo de Atención Primaria debe seleccionar a los pacientes hipertensos candidatos a realizar la consulta telemática proactivamente, informando de la cita con antelación. Al iniciar la consulta telemática, se recomienda explicar el motivo y los objetivos de la misma, y realizar la anamnesis preguntando por signos y síntomas de empeoramiento de la enfermedad, tratamientos actuales y adherencia a los mismos. En pacientes con una automedida de la presión arterial (AMPA) ≤ 135/85 mmHg se recomienda pautar una nueva cita telemática en 3-6 meses. Por el contrario, en pacientes asintomáticos que reporten una AMPA ≥ 135/85 mmHg se recomienda la monitorización ambulatoria de la presión arterial, modificar el tratamiento, o derivar al paciente a visita presencial o al hospital en caso de signos o síntomas de alarma.

Conclusiones

La teleconsulta puede complementar la consulta presencial, constituyendo un elemento más a tener en cuenta para el adecuado control de los pacientes hipertensos.

SEA 2022 Standards for Global Control of Cardiovascular Risk

One of the objectives of the Spanish Society of Arteriosclerosis is to contribute to better knowledge of vascular disease, its prevention and treatment. It is well known that cardiovascular diseases are the leading cause of death in our country and entail a high degree of disability and health care costs. Arteriosclerosis is a multifactorial disease and therefore its prevention requires a global approach that takes into account the different risk factors with which it is associated. Therefore, this document summarizes the current level of knowledge and includes recommendations and procedures to be followed in patients with established cardiovascular disease or at high vascular risk. Specifically, this document reviews the main symptoms and signs to be evaluated during the clinical visit, the laboratory and imaging procedures to be routinely requested or requested for those in special situations. It also includes vascular risk estimation, the diagnostic criteria of the different entities that are cardiovascular risk factors, and makes general and specific recommendations for the treatment of the different cardiovascular risk factors and their final objectives. Finally, the document includes aspects that are not usually referenced in the literature, such as the organization of a vascular risk consultation.