Identificação De Pacientes Com Hipertensão Resistente E Pseudorresistente Em Uma Unidade De Saúde Da Família

Abstract

Resistant Hypertension manifests when blood pressure (BP) remains above the recommended levels, despite regular use of three classes of antihypertensive drugs, including diuretics. This study aimed to identify resistant hypertension and pseudo-resistant hypertension in patients enrolled in a Family Health Unit. It was a cross-sectional study in hypertensive patients using antihypertensive medications seen at Basic Health Unit (BHU), located in the city of Maceio, through interviews with a structured questionnaire during home visits, as well as searching information from patients medical records at BHU. Patients were monitored for three consecutive weeks. The adherence was determined by applying the Morisky Adherence Scale Therapeutics eight items (MMAS-8). The antihypertensive drug therapy was evaluated according to the Brazilian Guidelines on Hypertension. Fifty 50 patients were investigated, with mean age of 66.4 years (SD = 13.5). Most hypertensive patients studied were female (74%). Among the patients, 39 were classified as pseudo-resistant hypertension (78%), and 28 patients used antihypertensive regimens are considered inappropriate and 11 were non-adherent to treatment. In this study, 8% of hypertensive patients were diagnosed with resistant hypertension. Regarding SBP and DBP, gender, smoking habits and physical activity were not influencing factors. On the other hand, the proper prescription was correlated with the control of SBP, but not with the DBP control. The degree of adherence influenced both SBP and DBP. It was also observed the influence of subtype of hypertension on the SBP and DBP.Key Words: medication adherence; hypertension; inappropriate prescribing RESUMO A Hipertensão Resistente (HAR) se manifesta quando os valores de pressão arterial (PA) permanecem acima da meta, apesar do uso regular de três classes de fármacos anti-hipertensivos, incluindo um diurético. Este estudo teve como objetivo identificar a HAR e a hipertensão pseudo-resistente em pacientes atendidos em uma Unidade de Saúde da Família. Foi realizado um estudo transversal com pacientes hipertensos em uso de medicamentos anti-hipertensivos atendidos em uma Unidade Básica de Saúde localizada no município de Maceió, por meio de entrevistas, com aplicação de questionário estruturado durante visitas domiciliares. Os valores de PA dos pacientes foram monitorados durante três semanas consecutivas. A adesão terapêutica foi determinada por meio da aplicação da Escala de Adesão Terapêutica de oito itens de Morisky (MMAS-8). Foram investigados 50 pacientes, com média de idade de 66,4 anos (DP = 13,5), sendo que a maioria dos pacientes era do sexo feminino (74%). Entre os pacientes estudados, 39 foram