1
|
Pallarés-Carratalá V, Divisón Garrote JA, Prieto Díaz MA, García Matarín L, Seoane Vicente MC, Molina Escribano F, Velilla Zancada S, Rey Aldana D, Cinza Sanjurjo S, Santos Altozano C, Górriz JL, Alonso Moreno FJ, Polo García J, Barquilla García A, Beato Fernández P, Escobar Cervantes C. [Positioning for the management of arterial hypertension in Primary Care from the critical analysis of the American (2017) and European (2018) guidelines. Spanish Society of Primary Care Physicians (SEMERGEN)]. Semergen 2019; 45:251-272. [PMID: 31005506 DOI: 10.1016/j.semerg.2019.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 01/02/2019] [Accepted: 02/04/2019] [Indexed: 11/30/2022]
Abstract
The Scientific Societies of Primary Care, being the area in which there is a considerable prevalence of Arterial Hypertension (AHT), need to periodically evaluate the international guidelines for its management. This is particularly relevant when disparate guidelines make it difficult to make decisions in daily clinical practice. The present document has as its aim to analyse the changes and new developments proposed in the guidelines of the American College of Cardiology and the American Heart Association (ACC/AHA 2017), as well as in the guidelines of the European Society of Cardiology and European Society of Hypertension (ESC/ESH 2018). An analysis will be made of any differences, limitations, and their applicability to Primary Care in Spain. Finally, the most relevant available and appropriate information is extracted and integrated in order to homogenise the care of the hypertensive patient, from a critical, but also a reasoned, perspective. The discrepancies between the recommendations in such essential aspects as the management of the disease, require the compiling and critical analysis of the information that enables us as scientific society, interested in providing all PC physicians with the most relevant, and at the same time, sensible, recommendations of all the guidelines.
Collapse
Affiliation(s)
- V Pallarés-Carratalá
- Unidad de Vigilancia de la Salud, Unión de Mutuas, Castellón, España; Departamento de Medicina, Universitat Jaume I, Castellón, España.
| | - J A Divisón Garrote
- Centro de Salud Casas Ibañez, Casas Ibáñez, Albacete, España; Cátedra de Medicina de Familia SEMERGEN, Universidad Católica San Antonio de Murcia, Murcia, España.
| | | | | | | | - F Molina Escribano
- Centro de Salud Casas Ibañez, Consultorio Balsa de Ves, Balsa de Ves, Albacete, España
| | | | - D Rey Aldana
- Centro de Salud A Estrada, A Estrada, Pontevedra, España
| | - S Cinza Sanjurjo
- Cátedra SEMERGEN, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España; Centro de Salud Porto do Son, Porto de Son, A Coruña, España
| | | | - J L Górriz
- Servicio de Nefrología, Hospital Clínico de Valencia, Valencia, España; Departamento de Medicina, Facultad de Medicina, Universidad de Valencia, Valencia, España
| | | | - J Polo García
- Centro de Salud Casar de Cáceres, Casar de Cáceres, Cáceres, España
| | | | | | | |
Collapse
|
2
|
Barquilla García A, Llisterri Caro JL, Prieto Díaz MA, Alonso Moreno FJ, García Matarín L, Galgo Nafría A, Mediavilla Bravo JJ. [Blood pressure control in a population of hypertensive diabetic patients treated in primary care: PRESCAP-Diabetes Study 2010]. Semergen 2014; 41:13-23. [PMID: 24703582 DOI: 10.1016/j.semerg.2014.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 12/17/2013] [Revised: 02/12/2014] [Accepted: 02/12/2014] [Indexed: 11/19/2022]
Abstract
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.
Collapse
Affiliation(s)
- A Barquilla García
- Medicina de Familia y Comunitaria, Centro de Salud de Trujillo, Cáceres, España.
| | - J L Llisterri Caro
- Medicina de Familia y Comunitaria, Centro de Salud Ingeniero Joaquín Benlloch, Valencia, España
| | - M A Prieto Díaz
- Medicina de Familia y Comunitaria, Centro de Salud de Vallobín-La Florida, Oviedo, España
| | - F J Alonso Moreno
- Medicina de Familia y Comunitaria, Centro de Salud Sillería, Toledo, España
| | - L García Matarín
- Medicina de Familia y Comunitaria, Unidad de Gestión Clínica de Vicar, Almería, España
| | - A Galgo Nafría
- Medicina de Familia y Comunitaria, Centro de Salud Espronceda, Madrid, España
| | | |
Collapse
|