El control de la hipertensión arterial, una asignatura pendiente

Liprandi, Álvaro Sosa; Baranchuk, Adrián; Santi, Ricardo López; Wyss, Fernando; Piskorz, Daniel; Puente, Adriana; Ponte‐Negretti, Carlos I.; Múnera-Echeverri, Ana G.; Piñeiro, Daniel

doi:10.26633/rpsp.2022.147

Cited by 5 publications

(9 citation statements)

References 18 publications

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“…The frequency of BP measurements directly correlates with awareness of hypertension, a crucial element for diagnosis [ 4 , 19 ]. Evidently, and as this study demonstrates, the prevalence of undiagnosed hypertension remains stubbornly high over recent decades [ 12 , 20 , 22 ]. The stagnant state of HTN awareness and screening over the years is alarming.…”

Section: Discussionmentioning

confidence: 98%

“…It underscores the inadequacy of current methods used to detect HTN, even though BP measurements are straightforward and cost-effective. Addressing arterial hypertension is an ongoing challenge in this region [ 12 ], with Primary Health Care (PHC) being pivotal in early detection. Public health initiatives should prioritize the prevention, detection, treatment, and comprehensive cardiovascular risk management.…”

Section: Discussionmentioning

confidence: 99%

“…A more strategic, holistic, and long-lasting solution is urgently required to diminish the toll of CVD and bolster the resilience of healthcare infrastructures. PHC emerges as a pivotal force in streamlining the hypertension care continuum [ 12 , 37 ]. In LMICs, including countries like Colombia, there’s a noticeable deficit in preventive and screening cultures, leading people to seek medical attention predominantly when symptoms manifest.…”

Section: Discussionmentioning

confidence: 99%

“…A significant number remain undiagnosed due to asymptomatic nature of hypertension, reinforcing the "hypertension care gap" [ 4 ]. The challenge lies in early diagnosis, treatment adherence, and control to diminish cardiovascular mortality [ 11 , 12 , 14 ]. Disturbingly, 46% of hypertensive individuals are undiagnosed [ 15 ], and in a sample of adults aged 15–54, 66.8% were similarly undiagnosed [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Burden of undiagnosed hypertension and its associated factors: A challenge for primary health care in urban Colombia

Salazar Flórez,

Echeverri Rendón,

Giraldo Cardona

2023

PLoS ONE

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Background Arterial hypertension is one of the most prevalent chronic, non-communicable diseases and the leading preventable risk factor for cardiovascular disease (CVD) and all-cause mortality worldwide. Although its primary causes and consequences are preventable, it often remains undiagnosed. Consequently, this study aims to determine the prevalence and factors associated with normotensive, diagnosed, and undiagnosed hypertension in adults. Methods A cross-sectional, population-based study was conducted in Sabaneta, Colombia, between 2021 and 2022, with 286 adults aged 18 and older. Stratified and systematic random sampling methods were employed. The World Health Organization STEP survey and the Perez Rojas test were utilized to assess behavioral risk factors and sedentary lifestyles. Body mass index, waist circumference, and arterial tension were measured using standardized instruments. The prevalence of hypertension was then estimated. Risk factors influencing normotensive, diagnosed, and undiagnosed hypertension were analyzed using multinomial regression. The outcome variable comprised three categories: normotensive (reference category), diagnosed hypertension, and undiagnosed hypertension. The multinomial regression coefficients were exponentiated and are presented as relative risk ratios (RRR) with 95% confidence intervals (CI). The model was adjusted for sex and sample weight per neighborhood. Results The study revealed a hypertension prevalence of 38.5% and an undiagnosed hypertension rate of 50.9%. Those with undiagnosed hypertension were predominantly adults over 60 years (RRR = 0.68; 95% CI: 0.53–0.86), individuals with an elementary school education (RRR = 1.75; 95% CI: 1.27–2.42), those physically active (RRR = 1.52; 95% CI: 1.22–1.89), without prior diagnoses of chronic comorbidities (RRR = 1.42; 95% CI: 1.12–1.82), and with obesity (RRR = 2.25; 95% CI: 1.63–3.11) or overweight conditions (RRR = 1.70; 95% CI: 1.334–2.15). Conclusions Undiagnosed hypertension was significant among populations without risk conditions. There is an urgent need for community-based early detection and education strategies to mitigate this issue.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Burden of undiagnosed hypertension and its associated factors: A challenge for primary health care in urban Colombia

Salazar Flórez,

Echeverri Rendón,

Giraldo Cardona

2023

PLoS ONE

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“…Además, la sociedad civil de América Latina y el Caribe está trabajando para que se priorice el control de la hipertensión en la agenda política abogando por la inversión de recursos, el fortalecimiento de la concientización comunitaria y la generación de una demanda social activa [ 30 ]. Asimismo, la Sociedad Interamericana de Cardiología ha adoptado una posición firme de apoyo a la guía de la OMS para el tratamiento farmacológico de la hipertensión [ 31 , 32•• ] mediante la aplicación de la iniciativa HEARTS en toda esa región [ 33 ].…”

Section: Fortalecimiento De Un Sistema De Manejo Orientado a La Atenc...unclassified

HEARTS en las Américas: impulsar el cambio en el sistema de salud para mejorar el control de la hipertensión en la población

Ordunez,

Campbell,

DiPette

et al. 2024

Revista Panamericana De Salud Pública

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Propósito de la revisión. HEARTS en las Américas es la adaptación regional de la iniciativa mundial HEARTS, de la Organización Mundial de la Salud, para la prevención y el control de las enfermedades cardiovasculares (ECV). Su objetivo general es impulsar el cambio de la práctica clínica y de la gestión en los entornos de atención primaria, por parte de los servicios de salud, a fin de mejorar el control de la hipertensión y reducir el riesgo de ECV. En esta revisión se describe la iniciativa HEARTS en las Américas. En primer lugar, se resume la situación epidemiológica regional en cuanto a la mortalidad por ECV y las tendencias en el control de la hipertensión a nivel poblacional; a continuación, se explica la razón de ser de los principales componentes de la intervención: el sistema de manejo orientado a la atención primaria y la vía clínica de HEARTS. Por último, se examinan los factores clave para acelerar la expansión de HEARTS: los medicamentos, la atención basada en el trabajo en equipo y un sistema de monitoreo y evaluación. Resultados recientes. Hasta el momento, 33 países y territorios de América Latina y el Caribe se han comprometido a integrar este programa en toda su red de atención primaria de salud para el 2025. El aumento de la cobertura y del control de la hipertensión en los entornos de atención primaria de salud (en comparación con el modelo tradicional) es prometedor y confirma que las intervenciones que se promueven como parte de HEARTS son factibles y resultan aceptables para las comunidades, los pacientes, los prestadores de servicios de salud, los responsables de la toma de decisiones y los financiadores. En esta revisión se destacan algunos casos de implementación satisfactoria. Conclusiones. Ampliar el uso de un tratamiento eficaz de la hipertensión y optimizar el control del riesgo de ECV es una forma pragmática de acelerar la reducción de la mortalidad por ECV y, al mismo tiempo, de fortalecer los sistemas de atención primaria de salud para responder con calidad y de manera eficaz y equitativa al desafío que entrañan las enfermedades no transmisibles, no solo en los países de ingresos bajos o medianos, sino en todas las comunidades a nivel mundial.

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HEARTS in the Americas: Targeting Health System Change to Improve Population Hypertension Control

Ordunez,

Campbell,

DiPette

et al. 2023

Curr Hypertens Rep

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Purpose of Review HEARTS in the Americas is the regional adaptation of Global Hearts, the World Health Organization initiative for cardiovascular disease (CVD) prevention and control. Its overarching goal is to drive health services to change managerial and clinical practice in primary care settings to improve hypertension control and CVD risk management. This review describes the HEARTS in the Americas initiative. First, the regional epidemiological situation of CVD mortality and population hypertension control trends are summarized; then the rationale for its main intervention components: the primary care-oriented management system and the HEARTS Clinical Pathway are described. Finally, the key factors for accelerating the expansion of HEARTS are examined: medicines, team-based care, and a system for monitoring and evaluation. Recent Findings Thus far, 33 countries in Latin America and the Caribbean have committed to integrating this program across their primary healthcare network by 2025. The increase in hypertension coverage and control in primary health care settings compared with the traditional model is promising and confirms that the interventions under the HEARTS umbrella are feasible and acceptable to communities, patients, providers, decision-makers, and funders. This review highlights some cases of successful implementation. Summary Scaling up effective treatment for hypertension and optimization of CVD risk management is a pragmatic way to accelerate the reduction of CVD mortality while strengthening primary healthcare systems to respond effectively, with quality, and equitably, to the challenge of non-communicable diseases, not only in low-middle income countries but in all communities globally.

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El control de la hipertensión arterial, una asignatura pendiente

Cited by 5 publications

References 18 publications

Burden of undiagnosed hypertension and its associated factors: A challenge for primary health care in urban Colombia

Burden of undiagnosed hypertension and its associated factors: A challenge for primary health care in urban Colombia

HEARTS en las Américas: impulsar el cambio en el sistema de salud para mejorar el control de la hipertensión en la población

HEARTS in the Americas: Targeting Health System Change to Improve Population Hypertension Control

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