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Pallarés-Carratalá V, Ruiz-García A, Serrano-Cumplido A, Arranz-Martínez E, Divisón-Garrote JA, Moyá-Amengual A, Escobar-Cervantes C, Barrios V. Prevalence Rates of Arterial Hypertension According to the Threshold Criteria of 140/90 or 130/80 mmHg and Associated Cardiometabolic and Renal Factors: SIMETAP-HTN Study. Medicina (Kaunas) 2023; 59:1846. [PMID: 37893564 PMCID: PMC10608132 DOI: 10.3390/medicina59101846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/29/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
Background and objectives: Arterial hypertension (HTN) is the leading preventable cause of atherosclerotic cardiovascular diseases (ASCVD) and death from all causes. This study aimed to determine the prevalence rates of HTN diagnosed according to the threshold diagnostic criteria 130/80 mmHg and 140/90 mmHg, to compare blood pressure (BP) control, and to evaluate their associations with cardiovascular diseases and cardiometabolic and renal risk factors. Materials and Methods: This was a cross-sectional observational study conducted in primary care with a population-based random sample: 6588 people aged 18.0-102.8 years. Crude and adjusted prevalence rates of HTN were calculated. BP control was compared in HTN patients with and without ASCVD or chronic kidney disease (CKD). Their associations with cardiovascular diseases and cardiometabolic and renal factors were assessed using bivariate and multivariate analysis. Results: Adjusted prevalence rates of HTN diagnosed according to 140/90 and 130/90 criteria were 30.9% (32.9% male; 29.7% female) and 54.9% (63.2% male; 49.3% female), respectively. BP < 130/80 mmHg was achieved in 60.5% of HTN patients without ASCVD or CKD according to 140/90 criterion, and 65.5% according to 130/80 criterion. This BP-control was achieved in 70% of HTN patients with ASCVD and 71% with CKD, according to both criteria. Coronary heart disease (CHD), heart failure, atrial fibrillation, stroke, diabetes, prediabetes, low glomerular filtration rate (eGFR), hyperuricemia, hypercholesterolemia, obesity, overweight, and increased waist-to-height ratio were independently associated with HTN according to both criteria. Conclusions: Almost a third of the adult population has HTN according to the 140/90 criterion, and more than half according to the 130/90 criterion, with a higher prevalence in men. The main clinical conditions associated with HTN were heart failure, diabetes, CHD, low eGFR, and obesity.
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Affiliation(s)
- Vicente Pallarés-Carratalá
- Health Surveillance Unit, Mutual Insurance Union, 12004 Castellon, Spain
- Department of Medicine, Jaume I University, 12006 Castellon, Spain
| | - Antonio Ruiz-García
- Lipids and Cardiovascular Prevention Unit, Pinto University Health Centre, Pinto, 28320 Madrid, Spain
- Department of Medicine, European University of Madrid, Villaviciosa de Odon, 28670 Madrid, Spain
| | | | | | | | | | | | - Vivencio Barrios
- Ramon y Cajal University Hospital, 28034 Madrid, Spain;
- Department of Medicine, Alcala University, 28801 Madrid, Spain
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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. Hipertens Riesgo Vasc 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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Nieto Iglesias J, Abellán-Huerta J, García López JC, Tárraga López PJ, Divisón-Garrote JA. Update on smoking. Alternatives for the management of patients with cardiovascular risk. Hipertens Riesgo Vasc 2021; 38:178-185. [PMID: 33926853 DOI: 10.1016/j.hipert.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 04/04/2021] [Indexed: 10/21/2022]
Abstract
Smoking is the leading cause of morbidity and mortality worldwide and is clearly involved as a cardiovascular risk factor. Smoking has different effects on the cardiovascular system, such as a decrease in nitric oxide, increased inflammatory response, increased adhesion of pro-atherogenic molecules, lipid disturbances, generation of oxidative stress and endothelial dysfunction as can be shown in different biomarkers modifications. Despite the aids currently available for smoking cessation, many smokers are unwilling or unable to achieve this. So alternative tools with potential harm reduction, such as non-combustion tobacco products, could be an option due to the better results they had shown on cardiovascular risk factors. This has led these devices to be taken into account as a risk-modifying tobacco product according to the FDA.
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Affiliation(s)
- J Nieto Iglesias
- Unidad de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
| | - J Abellán-Huerta
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - J C García López
- Servicio de Cardiología, Hospital General Universitario de Albacete, Albacete, Spain
| | - P J Tárraga López
- Centro de Salud Zona 5, Complejo Hospitalario Universitario de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | - J A Divisón-Garrote
- Centro de Salud de Casas Ibáñez (Albacete), Universidad Católica San Antonio de Murcia (UCAM), Spain
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Divisón-Garrote JA, Prieto-Díaz MÁ, Alonso-Moreno FJ, Velilla-Zancada SM, Escobar-Cervantes C, Llisterri-Caro JL, Cinza-Sanjurjo S, Rodríguez-Roca GC, Polo-García J, Pallarés-Carratalá V. Prevalence of hypotension in hypertensive treated patients within the Primary Care setting. The PRESCAP 2010 study. Semergen 2019; 46:107-114. [PMID: 31395479 DOI: 10.1016/j.semerg.2019.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 06/23/2019] [Accepted: 07/05/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the prevalence of hypotension and associated factors in hypertensive patients treated in the Primary Care setting. MATERIALS AND METHODS A cross-sectional, descriptive, and multicentre study was conducted with a total of 2635 general practitioners consecutively including 12,961 hypertensive patients treated in a Primary Care setting in Spain. An analysis was performed on the variables of age, gender, weight, height, body mass index, waist circumference, cardiovascular risk factors (diabetes, dyslipidaemia, smoking, obesity, sedentary lifestyle), fasting plasma glucose, complete lipid profile, as well as the presence of target organ damage (left ventricular hypertrophy, microalbuminuria, carotid atherosclerosis) and associated clinical conditions. Hypotension was defined as a systolic blood pressure less than 110mmHg or a diastolic blood pressure less than 70mmHg. A multivariate analysis was performed to determine the variables associated with the presence of hypotension. RESULTS The mean age was 66.2 years, and 51.7% of patients were women. The mean time of onset of hypertension was 9.1 years. A total of 13.1% of patients (95% confidence interval 12.4-13.6%) had hypotension, 95% of whom had low diastolic blood pressure. The prevalence of hypotension was higher in elderly patients (25.7%) and in those individuals with coronary heart disease (22.6%). The variables associated with the presence of hypotension included a history of cardiovascular disease, being treated with at least 3 antihypertensive drugs, diabetes, and age. CONCLUSIONS One out of 4-5 elderly patients, or those with cardiovascular disease, had hypotension. General practitioners should identify these patients in order to determine the causes and adjust treatment to avoid complications.
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Affiliation(s)
- J A Divisón-Garrote
- Centro de Salud Casas Ibañez, Albacete, Spain; Director Cátedra de Medicina de Familia SEMERGEN, Universidad Católica San Antonio de Murcia, Spain
| | - M Á Prieto-Díaz
- Centro de Salud Vallobín-La Florida, Oviedo, Spain; Doctorando en Facultad de Medicina, Cátedra Universidad Santiago de Compostela - SEMERGEN, Spain.
| | | | | | | | | | - S Cinza-Sanjurjo
- Centro de Salud Porto do Son, A Coruña, Spain; Cátedra SEMERGEN Universidad de Santiago de Compostela, Spain
| | | | - J Polo-García
- Centro de Salud Centro de Salud Casar de Cáceres, Cáceres, Spain
| | - V Pallarés-Carratalá
- Unidad de Vigilancia de la Salud, Unión de Mutuas, Castellón, Spain; Departamento de Medicina, Universitat Jaume I, Castellón, Spain
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Gijón-Conde T, Gorostidi M, Banegas JR, de la Sierra A, Segura J, Vinyoles E, Divisón-Garrote JA, Ruilope LM. [Position statement on ambulatory blood pressure monitoring (ABPM) by the Spanish Society of Hypertension (2019)]. Hipertens Riesgo Vasc 2019; 36:199-212. [PMID: 31178410 DOI: 10.1016/j.hipert.2019.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 05/17/2019] [Indexed: 11/19/2022]
Abstract
Conventional blood pressure (BP) measurement in clinical practice is the most used procedure for the diagnosis and treatment of hypertension (HT), but is subject to considerable inaccuracies due to, on the one hand, the inherent variability of the BP itself and, on the other hand biases arising from the measurement technique and conditions, Some studies have demonstrated the prognosis superiority in the development of cardiovascular disease using ambulatory blood pressure monitoring (ABPM). It can also detect "white coat" hypertension, avoiding over-diagnosis and over-treatment in many cases, as well detecting of masked hypertension, avoiding under-detection and under-treatment. ABPM is recognised in the diagnosis and management of HT in most of international guidelines on hypertension. The present document, taking the recommendations of the European Society of Hypertension as a reference, aims to review the more recent evidence on ABPM, and to serve as guidelines for health professionals in their clinical practice and to encourage ABPM use in the diagnosis and follow-up of hypertensive subjects. Requirements, procedure, and clinical indications for using ABPM are provided. An analysis is also made of the main contributions of ABPM in the diagnosis of "white coat" and masked HT phenotypes, short term BP variability patterns, its use in high risk and resistant hypertension, as well as its the role in special population groups like children, pregnancy and elderly. Finally, some aspects about the current situation of the Spanish ABPM Registry and future perspectives in research and potential ABPM generalisation in clinical practice are also discussed.
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Affiliation(s)
- T Gijón-Conde
- Centro de Salud Universitario Cerro del Aire, Majadahonda, Madrid, España; Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma Madrid/IdiPAZ y CIBERESP, Madrid, España.
| | - M Gorostidi
- Servicio de Nefrología, Hospital Universitario Central de Asturias, RedinRen, Universidad de Oviedo, Oviedo, Asturias, España.
| | - J R Banegas
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma Madrid/IdiPAZ y CIBERESP, Madrid, España
| | - A de la Sierra
- Departamento de Medicina Interna, Hospital Mutua Terrassa, Universidad de Barcelona, Terrassa, Barcelona, España
| | - J Segura
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, España; Unidad de Hipertensión, Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, España
| | - E Vinyoles
- Centre d' Atenció Primària La Mina, Departamento de Medicina, Universidad de Barcelona, Barcelona, España
| | - J A Divisón-Garrote
- Centro de Salud de Casas Ibáñez, Albacete, Universidad Católica San Antonio, Murcia, España
| | - L M Ruilope
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma Madrid/IdiPAZ y CIBERESP, Madrid, España; Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, España; Escuela de Estudios de Doctorado e Investigación, Universidad Europea de Madrid, Madrid, España
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Artigao-Ródenas LM, Carbayo-Herencia JA, Palazón-Bru A, Divisón-Garrote JA, Sanchis-Domènech C, Vigo-Aguiar I, Gil-Guillén VF. Construction and Validation of a 14-Year Cardiovascular Risk Score for Use in the General Population: The Puras-GEVA Chart. Medicine (Baltimore) 2015; 94:e1980. [PMID: 26632692 PMCID: PMC5058961 DOI: 10.1097/md.0000000000001980] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
UNLABELLED The current cardiovascular risk tables are based on a 10-year period and therefore, do not allow for predictions in the short or medium term. Thus, we are unable to take more aggressive therapeutic decisions when this risk is very high.To develop and validate a predictive model of cardiovascular disease (CVD), to enable calculation of risk in the short, medium and long term in the general population.Cohort study with 14 years of follow-up (1992-2006) was obtained through random sampling of 342,667 inhabitants in a Spanish region. MAIN OUTCOME time-to-CVD. The sample was randomly divided into 2 parts [823 (80%), construction; 227 (20%), validation]. A stepwise Cox model was constructed to determine which variables at baseline (age, sex, blood pressure, etc) were associated with CVD. The model was adapted to a points system and risk groups based on epidemiological criteria (sensitivity and specificity) were established. The risk associated with each score was calculated every 2 years up to a maximum of 14. The estimated model was validated by calculating the C-statistic and comparison between observed and expected events.In the construction sample, 76 patients experienced a CVD during the follow-up (82 cases per 10,000 person-years). Factors in the model included sex, diabetes, left ventricular hypertrophy, occupational physical activity, age, systolic blood pressure × heart rate, number of cigarettes, and total cholesterol. Validation yielded a C-statistic of 0.886 and the comparison between expected and observed events was not significant (P: 0.49-0.75).We constructed and validated a scoring system able to determine, with a very high discriminating power, which patients will develop a CVD in the short, medium, and long term (maximum 14 years). Validation studies are needed for the model constructed.
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Affiliation(s)
- Luis Miguel Artigao-Ródenas
- Zone III Primary Health Care Centre, Health Service of Castilla-La Mancha, Albacete (LMA-R); San Antonio Catholic University, Murcia (JAC-H, JAD-G); Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante (JAC-H, AP-B, VFG-G); Research Unit, Elda General Hospital, Elda (AP-B, VFG-G); Casas Ibáñez Primary Health Care Centre, Health Service of Castilla-La Mancha, Albacete (JAD-G); Health Center of Algemesi, Generalitat Valenciana, Algemesi, Valencia (CS-D); and Department of Applied Mathematics, University of Alicante, Alicante, Spain (IV-A)
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Ponce-Garcia I, Simarro-Rueda M, Carbayo-Herencia JA, Divisón-Garrote JA, Artigao-Ródenas LM, Botella-Romero F, Palazón-Bru A, Martínez-St. John DRJ, Gil-Guillén VF. Prognostic value of obesity on both overall mortality and cardiovascular disease in the general population. PLoS One 2015; 10:e0127369. [PMID: 25992570 PMCID: PMC4438865 DOI: 10.1371/journal.pone.0127369] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 04/14/2015] [Indexed: 12/25/2022] Open
Abstract
Background Obesity represents an important health problem and its association with cardiovascular risk factors is well-known. The aim of this work was to assess the correlation between obesity and mortality (both, all-cause mortality and the combined variable of all-cause mortality plus the appearance of a non-fatal first cardiovascular event) in a general population sample from the south-east of Spain. Materials and Methods This prospective cohort study used stratified and randomized two-stage sampling. Obesity [body mass index (BMI) ≥30 kg/m2] as a predictive variable of mortality and cardiovascular events was assessed after controlling for age, sex, cardiovascular disease history, high blood pressure, diabetes mellitus, hypercholesterolemia, high-density lipoprotein/triglycerides ratio, total cholesterol and smoking with the Cox regression model. Results The mean follow-up time of the 1,248 participants was 10.6 years. The incidence of all-cause mortality during this period was 97 deaths for every 10,000 person/years (95% CI: 80–113) and the incidence of all-cause mortality+cardiovascular morbidity was 143 cases for every 10,000 person/years (95% CI: 124–163). A BMI ≥35 kg/m2 yielded a hazard ratio for all-cause mortality of 1.94 (95% CI: 1.11–3.42) in comparison to non-obese subjects (BMI <30 kg/m2). For the combination of cardiovascular morbidity plus all-cause mortality, a BMI ≥35 kg/m2 had a hazard ratio of 1.84 (95% CI: 1.15–2.93) compared to non-obese subjects. Conclusions A BMI ≥35 kg/m2 is an important predictor of both overall mortality and of the combination of cardiovascular morbidity plus all-cause mortality.
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Affiliation(s)
- Isabel Ponce-Garcia
- Casas Ibáñez Primary Health Care Centre, Health Service of Castilla la Mancha, Albacete, Spain
| | - Marta Simarro-Rueda
- Zona IV Primary Health Care Centre, Health Service of Castilla la Mancha, Albacete, Spain
| | - Julio Antonio Carbayo-Herencia
- Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Spain
- Cátedra de Riesgo Cardiovascular, San Antonio Catholic University, Murcia, Spain
| | - Juan Antonio Divisón-Garrote
- Casas Ibáñez Primary Health Care Centre, Health Service of Castilla la Mancha, Albacete, Spain
- Cátedra de Riesgo Cardiovascular, San Antonio Catholic University, Murcia, Spain
| | | | - Francisco Botella-Romero
- Endocrinology and Nutrition Service, General Hospital, Albacete, Spain
- Castilla La Mancha School of Medicine, Albacete, Spain
| | - Antonio Palazón-Bru
- Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Spain
- Research Unit, Elda General Hospital, Elda, Spain
- * E-mail:
| | | | - Vicente Francisco Gil-Guillén
- Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Spain
- Research Unit, Elda General Hospital, Elda, Spain
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Cinza-Sanjurjo S, Alonso-Moreno FJ, Prieto-Díaz MÁ, Divisón-Garrote JA, Rodríguez-Roca GC, Llisterri-Caro JL. [Resistant arterial hypertension in Primary Care patients in Spain. PRESCAP Study 2010]. Semergen 2014; 41:123-30. [PMID: 24768029 DOI: 10.1016/j.semerg.2014.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 02/15/2014] [Accepted: 02/17/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine the prevalence and clinical and epidemiological characteristics of Primary Care patients with resistant hypertension (RHT) in Spain. PATIENTS AND METHODS A cross-sectional multicenter study was conducted on hypertensive patients aged 18 or over and seen in a Primary Care clinic. RHT was considered as the presence of uncontrolled blood pressure in patients treated with at least 3 drugs, one of which is a diuretic. RESULTS Of the 12,961 hypertensive patients in the PRESCAP 2010 study, 962 (7.4%) fulfilled criteria for RHT, of whom 51% were women, and with a mean age (SD) 68.8 [11.4] years. Patients with RHT were older (68.80 [10.69] years vs. 66.06 [11.44] years, P<.001), had a higher prevalence of obesity (55.2 vs. 38.6%, P<.001), a higher waist circumference (103.90 [13.89] vs. 99.32 [13.69] cm, P<.001), and a higher prevalence of DM (48.3 vs. 29.5%, P<.001). The prevalence of target organ damage (73.0 vs. 61.4%, P<.001) and cardiovascular disease (46.7 vs. 26.8%, P<.001) were higher in patients with resistant hypertension. The multivariate analysis showed that the variables associated with resistant hypertension were the presence of cardiovascular disease, diabetes mellitus, sedentary life style, microalbuminuria, body mass index, duration of AHT, and triglycerides. CONCLUSIONS The prevalence of RHT in Primary Care patients is related to inappropriate lifestyles, the presence of target organ damage, and cardiovascular disease.
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Affiliation(s)
- S Cinza-Sanjurjo
- Centro de Salud de Porto do Son, Porto do Son, A Coruña, España.
| | | | | | | | - G C Rodríguez-Roca
- Centro de Salud Puebla de Montalbán, La Puebla de Montalbán, Toledo, España
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