Conducta del médico de atención primaria ante el mal control de la presión arterial

Abstract

PC physicians behaviour was conservative in uncontrolled hypertension cases. Amongst the doctors who modified their behaviour, by inadequate blood pressure control, the change of drug was the decision most adopted.

Reasons for not achieving control: therapeutic inertia in monitoring hypertension in primary care.

“…Finally, of the subjects who did not require adjustments because their ABPM results indicated good BP control (88), 13.6% (12) did not come to the health centre to receive their results within the year after the study, and 5 patients ceased to be seen at the health centre (Table 3). Clinical inertia was more common in older patients (> 67.5 years [chi 2 p = 0.17]) and occurred in a greater proportion of males (p < 0.05) with an OR: 2.13 (95% CI:1-4.62).…”

“…Regarding the degree of control of the hypertensive patients in the sample, 42.5% of the 153 patients studied required readjustment of their treatment to improve their BP control; this nding was similar to the results of the 2010 PRESCAP study conducted nationwide, in which nearly 4 of every 10 patients had poorly controlled BP 10,11 . The difference between our study and contrasting studies is that the follow-up of our hypertensive patients was based on ABPM values, while the others used BP measurements performed at doctor or nurse visit for diagnosis 12 . One year later, we examined the patients' clinical history via their electronic medical records and con rmed that therapeutic measures were taken for only 45% of the patients with poor BP control.…”