[Blood pressure control in a population of hypertensive diabetic patients treated in primary care: PRESCAP-Diabetes Study 2010]

OBJECTIVES

To determine the level of blood pressure (BP) control in hypertensive diabetic patients treated in primary care and to determine the factors associated with poor control.

MATERIAL AND METHODS

A cross-sectional, multicentre study that enrolled hypertensive diabetics recruited by consecutive sampling by family doctors in Spain in June 2010. A mean BP of less than 140/90mmHg was considered as good control of arterial hypertension. The percentages of patients with<130/80mmHg PA, 140/80mmHg, and 140/85mmHg, respectively, were also determined. Sociodemographic, clinical, cardiovascular risk factors, and pharmacological treatments were recorded.

RESULTS

A total of 3,993 patients were enrolled (50.1% female) with a mean age (standard deviation) of 68.2 (10.2) years, of whom 73.9% received combination therapy. The figures showed good control of both blood pressure values (<140/90mmHg) in 56.4% (95% CI: 54.3 to 58.4) of the cases, with 58.5% (95% CI: 57.0-60.0) only in systolic BP, and 84.6% (95% CI, 83.2 to 85.8) only in diastolic BP. The variables with strongest association with poor control were the presence of albuminuria, elevated total cholesterol, physical inactivity, and not taking the medication on the day of the interview.

CONCLUSIONS

The PRESCAP-Diabetes 2010 study results indicate that 43.6% of diabetics with hypertension seen in primary care have a poorly controlled BP, in particular, systolic BP.

[An analysis of the referrals of primary care physicians to a hospital hypertension unit]

OBJECTIVES

To describe the referral of hypertense patients from primary care to a hospital arterial hypertension unit, the quality of the information sent and the profile of the referred patients.

DESIGN

A descriptive crossover study.

SETTING

The Hospital Clínico of San Carlos in Madrid.

PATIENTS AND OTHER PARTICIPANTS

A simple random sample of 368 clinical records belonging to patients attended at the unit over the last 3 years.

MEASUREMENTS AND MAIN RESULTS

54.6% of patients were referred from primary care. 48.9% of the interclinical (IC) notes were high-quality, with 28.7% acceptable. 36.8% of referrals were considered incorrect, 30.3% because of false unresponsiveness to treatment. Good or acceptable IC notes were associated with 94.1% of correct referrals and only 65.4% of incorrect referrals.

CONCLUSIONS

A high proportion of referrals which were incorrect by the consensus criteria were detected and were caused by inadequate or insufficient medical treatment. There was a statistically significant relationship found between correct referrals and the quality of information sent in the IC note.