1
|
Prieto-Díaz MA, Pallares-Carratala V, Manuel Micó-Pérez R, Escobar-Cervantes C, Martín-Sanchez V, Coca A, Barquilla-García A, Velilla-Zancada SM, Polo-García J, Segura-Fragoso A, Ginel-Mendoza L, Hermida-Ameijerias Á, Cinza-Sanjurjo S. Clinical characteristics, treatment, and blood pressure control in patients with hypertension seen by primary care physicians in Spain: the IBERICAN study. Front Cardiovasc Med 2023; 10:1295174. [PMID: 38173815 PMCID: PMC10763308 DOI: 10.3389/fcvm.2023.1295174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/29/2023] [Indexed: 01/05/2024] Open
Abstract
Objectives To determine the clinical profile, according to the history of hypertension, the risk of developing hypertension, current antihypertensive treatment and BP control rates in patients with hypertension from the IBERICAN cohort. Methods IBERICAN is an ongoing prospective cohort study, whose primary objective is to determine the frequency, incidence, and distribution of CVRF in the adult Spanish population seen in primary care settings. This analysis shows the baseline clinical characteristics of patients with hypertension. Adequate BP control was defined as BP <140/90 mmHg according to 2013 ESH/ESC guidelines. Results A total of 8,066 patients were consecutively included, of whom 3,860 (48.0%) had hypertension. These patients were older (65.8 ± 10.9 vs. 51.6 ± 14.7 years; p < 0.001), had more cardiovascular risk factors, target organ damage and cardiovascular disease (CVD) in comparison with those without hypertension. The risk of hypertension increased with the presence of associated CV risk factors and comorbidities, particularly diabetes, obesity and the metabolic syndrome, and decreased with the intensity of physical activity. Regarding antihypertensive treatments, 6.1% of patients did not take any medication, 38.8% were taking one antihypertensive drug, 35.5% two drugs, and 19.6% three or more antihypertensive drugs. Overall, 58.3% achieved BP goals <140/90 mmHg. A greater probability of BP control was observed with increasing age of patients and the greater number of antihypertensive drugs. Blood pressure control was lower in hypertensive patients with diabetes, obesity, the metabolic syndrome, increased urinary albumin excretion, higher pulse pressure, and lack of antihypertensive treatment. Conclusions About half of patients attended in primary care settings have hypertension in Spain. Patients with hypertension have a worse CV clinical profile than non-hypertensive patients, with greater association of CVRF and CVD. Around four out of ten patients do not achieve the recommended BP goals, and higher use of combination therapies is associated with a better BP control.
Collapse
Affiliation(s)
- Miguel A. Prieto-Díaz
- Vallobín-La Florida Health Center, Principality of Asturias Health Service, Oviedo, Spain
- Faculty of Medicine, University of Santiago de Compostela, A Coruña, Spain
| | - Vicente Pallares-Carratala
- Health Surveillance Unit, Mutual Insurance Union, Castellon, Spain
- Department of Medicine, Jaume I University, Castellon, Spain
| | | | | | - Vicente Martín-Sanchez
- Institute of Biomedicine (IBIOMED), Epidemiology and Public Health Networking Biomedical Research Centre (CIBERESP), University of León, León, Spain
| | - Antonio Coca
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | | | | | - José Polo-García
- Casar de Cáceres Health Center, Extremadura Health Service, Cáceres, Spain
| | | | | | | | - Sergio Cinza-Sanjurjo
- Milladoiro Health Centre, Health Area of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
- Networking Biomedical Research, Centre-Cardiovascular Diseases (CIBERCV), Santiago de Compostela, Spain
| | | |
Collapse
|
2
|
Guía práctica sobre el diagnóstico y tratamiento de la hipertensión arterial en España, 2022. Sociedad Española de Hipertensión - Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA). HIPERTENSION Y RIESGO VASCULAR 2022; 39:174-194. [DOI: 10.1016/j.hipert.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/06/2022] [Indexed: 01/08/2023]
|
4
|
Gijón-Conde T, Rubio E, Gorostidi M, Vinyoles E, Armario P, Rodilla E, Segura J, Divisón-Garrote JA, García-Donaire JA, Molinero A, Ruilope LM. 2021 Spanish Society of Hypertension position statement about telemedicine. HIPERTENSION Y RIESGO VASCULAR 2021; 38:186-196. [PMID: 33888438 PMCID: PMC8054212 DOI: 10.1016/j.hipert.2021.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 12/01/2022]
Abstract
The pandemic caused by coronavirus SARS-CoV-2 (COVID-19) has forced, in many cases, to replace face-to-face consultation with the telematic consultation, in order to reduce the risk of contagion associated with the presence of patients in health centres. This change may represent an opportunity for a different and more effective communication between professionals and patients, allowing better accessibility to medical care and more systematic and comprehensive approach to patients with hypertension and cardiovascular risk. However, organisational tools are needed to facilitate communication between patients and professionals, specifically with the exchange of clinical data by remote monitoring of variables associated with hypertension and cardiovascular risk (blood pressure, weight, height, blood tests…), and allow monitoring of adherence to treatments, lifestyles and risk factors. It would be desirable for this to be carried out by multidisciplinary teams, both from primary care, hospital and community pharmacy, with an adequate coordination of care. This document of the Spanish Society of Hypertension (SEH-LELHA) tries to give the keys to improve the quality of care of telematic consultations of patients with hypertension and cardiovascular risk, provide basic criteria of telematic or face to face attention and systematise their content. Likewise, the follow-up criteria are proposed by the different professionals.
Collapse
Affiliation(s)
- T Gijón-Conde
- Centro de Salud Cerro del Aire, Departamento de Medicina, Universidad Autónoma Madrid/IdiPAZ y CIBERESP, Majadahonda, Madrid, Spain.
| | - E Rubio
- Servicio de Nefrología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
| | - M Gorostidi
- Servicio de Nefrología, Hospital Universitario Central de Asturias, RedinRen, Universidad de Oviedo, Oviedo, Spain
| | - E Vinyoles
- Centre d'Atenció Primària La Mina, Departamento de Medicina, Universidad de Barcelona, Barcelona, Spain
| | - P Armario
- Área Atención Integrada de Riesgo Vascular, Departamento de Medicina Interna, Hospital Moisès Broggi Sant Joan Despi, Universidad de Barcelona, Sant Joan Despí, Barcelona, Spain
| | - E Rodilla
- Servicio de Medicina Interna, Hospital Universitario de Sagunto, Universidad Cardenal Herrera-CEU, Sagunto, Valencia, Spain
| | - J Segura
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain; Unidad de Hipertensión, Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J A Divisón-Garrote
- Centro de Salud de Casas Ibáñez, Universidad Católica San Antonio, Casas Ibáñez, Albacete, Spain
| | | | - A Molinero
- Sociedad Española de Farmacia Comunitaria (SEFAC), Spain
| | - L M Ruilope
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain; Unidad de Hipertensión, Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain; Escuela de Estudios de Doctorado e Investigación, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| |
Collapse
|