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. 2013 Apr 5;29(9):540–546. [Article in Spanish] doi: 10.1016/S0212-6567(02)70634-3

Valoración del tratamiento farmacológico antihipertensivo en un centro de salud en función de las patologías crónicas asociadas y grado de control de la HTA

Assessment of drug treatment for hypertension in a health centre as a function of associated chronic pathologies and degree of control of the hypertension

M Pérez García a,*, R Fernández Álvarez a, P Gayoso Diz b, A Martínez Vidal a
PMCID: PMC7684160  PMID: 12061984

Abstract

Objective

To assess the suitability of whatever hypertension medication is prescribed for the associated pathology in each patient, and to analyse the monitoring of blood pressure figures.

Design

A cross-sectional descriptive study.

Setting

Urban health centre.

Patients

The target population were the hypertension patients being treated with medication and monitored at the health centre. Stratified random sampling by quotas of the total number with hypertension was performed. The sample numbered 219 patients.

Measurements

The clinical history of each patient selected was reviewed. To evaluate the hypertension treatment, we established three levels of suitability with regard to the accompanying pathology of each patient (suitable, intermediate, unsuitable), using the 1999 Hypertension Protocol of the Spanish Society of Family and Community Medicine.

Results

Out of 219 cases, treatment was suitable in 71 (32.4%), intermediate in 91 (41.6%), and unsuitable in 57 (26%). The most frequently indicated drug group was the angiotensin converting enzyme inhibitor (ACEI) group and, jointly, ACEI and diuretics. Regarding the monitoring of blood pressure: 66.5% had very good monitoring, 23.2% partial and 9% poor.

Conclusions

Most treatments are at an intermediate level of suitability: without beneficial or undesirable effects on the associated pathology. This makes us think we need to optimize the drug indicators for hypertension.

Key words: Hypertension, Prescription, Quality, Hypertension drug

Bibliografía

  • 1.Ministerio de Sanidad y Consumo . Sociedad-Liga Española para la Lucha contra la Hipertensión Arterial. Control de la hipertensión arterial en España, 1996. Ministerio de Sanidad y Consumo; Madrid: 1996. [Google Scholar]
  • 2.Benegas J.R., Villar F., Pérez C., Jiménez R., Gil E., Muñiz J. Estudio epidemiológico de los factores de riesgo cardiovascular en la población española de 35 a 64 años. Rev San Hig Pub. 1993;67:419–445. [PubMed] [Google Scholar]
  • 3.The Sixth Report of the Joint National Committe on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Arch Intern Med. 1997;157:2413–2446. doi: 10.1001/archinte.157.21.2413. [DOI] [PubMed] [Google Scholar]
  • 4.National Heart, Lung, and Blood Institute staff . Calculated data. NHLBI; Bethesda: 1997. [Google Scholar]
  • 5.Gavras I., Manolis A., Gavras H. Drug therapy for hypertension. Am Fam Physician. 1997;55:1823–1834. [PubMed] [Google Scholar]
  • 6.Organización Mundial de la Salud y Sociedad Internacional de Hipertensión Recomendaciones (1999) para el tratamiento de la hipertensión arterial. Hypertension. 1999;16:206–244. [Google Scholar]
  • 7.Gong L., Zhang W., Zhu Y., Zhu J., Kong D., Pagé V. Shanghai trial of nifedipine in the elderly (STONE) J Hypertens. 1996;14:1237–1245. doi: 10.1097/00004872-199610000-00013. [DOI] [PubMed] [Google Scholar]
  • 8.Hansson L., Zamchetti A., Carruthers S.G., Dahlof B., Elmfeldt D., Julius S. Effects of intensive blood pressure lowering and low-dose aspirina in patients with hypertension: principal results of the hypertension optimal treatment (HOT) randomisef trial. HOT Study Group. Lancet. 1998;351:1755–1762. doi: 10.1016/s0140-6736(98)04311-6. [DOI] [PubMed] [Google Scholar]
  • 9.Dahlof B., Lindholm L.H., Hansson L., Schersten B., Ekbom T., Wester P.O. Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension) Lancet. 1991;338:1281–1285. doi: 10.1016/0140-6736(91)92589-t. [DOI] [PubMed] [Google Scholar]
  • 10.SHEP Cooperative Research Group Prevention of stroke by antihipertensive drug treatment in older persons with isolated systolic hypertension in the Elderly Program (SHEP) JAMA. 1991;265:3255–3264. [PubMed] [Google Scholar]
  • 11.Brown M.J., Palmer C.R., Castaigue A., De Leeuw, Mancia G., Rosenthal T. Morbilidad y mortalidad en pacientes aleatorizados a un tratamiento doble ciego con un calcioantagonista de acción prolongada o un diurético en el Internacional Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT) Lancet. 2000;356:366–372. [Google Scholar]
  • 12.Neal B., Macmahon S., Chapman N. Effects of angiotensin-converting enzyma inhibition compared with conventional therapy on cardiovascular morbility and mortality in hypertension: the captopril Prevention projet (CAPP) study. Curr Hipertens Rep. 1999;1:466–467. [PubMed] [Google Scholar]
  • 13.Ruilope L.M. Consideraciones sobre la utilidad de los nuevos estudios de hipertensión arterial. MEDIFAM. 1997;7:207–210. [Google Scholar]
  • 14.Pascual J., Orte L., Ortuño J. Tratamiento básico de la hipertensión arterial. Tratamiento farmacológico. Med Clin (Barc) 1994;103:699–707. [PubMed] [Google Scholar]
  • 15.Baos V. La calidad en la prescripción de medicamentos. Inf Terp Sist Nac Salud. 1999;23:45–54. [Google Scholar]
  • 16.Sociedad Española de Medicina de Familia y Comunitaria Protocolo de hipertensión arterial en atención Primaria. FMC. 1999;6(Supl 3) [Google Scholar]
  • 17.Coca A., Soler J., Plana J., Roma J y los investigadores de la FEHTACC Control de la hipertensión arterial en unidades de hipertensión de hospitales comarcales. Resultados de un modelo de asistencia multicéntrica protocolizada. Hipertensión. 1997;14:4–11. [Google Scholar]
  • 18.Coca A. Evolución del control de la hipertensión arterial en España. Resultados del Estudio Controlpres 98. Hipertensión. 1998;15:298–307. [Google Scholar]
  • 19.Ayala V., Garrido A., Castillo C., Gil B., Calcerrada N., Jaramillo B. Valoración de la indicación de fármacos antihipertensivos en un Equipo de Atención Primaria. MEDIFAM. 1998;8:279–286. [Google Scholar]
  • 20.Xunta de Galicia. IGE. [en línea]. [05–03–2001]. Instituto Galego de Estadística. [06–02–2001]. Disponible en URL: http://www.xunta.es/auto/ige/Datos/Padron/indexpadron.htm
  • 21.Alonso F.J., García M., Laborda M., Hermoso A., López F. Análisis de costes farmacológicos en el tratamiento de la hipertensión arterial. Aproximación a un estudio coste-efectividad. Aten Primaria. 1998;21:607–612. [PubMed] [Google Scholar]
  • 22.Burt V.L., Cutler J.A., Higgins M. Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population: data from the health examination surveys, 1960 to 1991. Hypertension. 1995;26:60–69. doi: 10.1161/01.hyp.26.1.60. [DOI] [PubMed] [Google Scholar]
  • 23.Frolich E.D., Grim C., Labarthe D.R., Maxwell M.h., Perioff D., Weidman W.H. Recommendations for human blood pressure determination by sphyngomanometers. Report of a special task force appointed by the Steering Committee, American Heart Association. Hypertension. 1988;11:209–222. [Google Scholar]
  • 24.Jassim Al-Khaja K.A., Sequeira R.P., Mathur V.S. Patterns of utilization of antihypertensive drug combinations in Bahrain: do they conform with international guidelines? Int J Clin Pharmacol. 2000;38:568–580. doi: 10.5414/cpp38568. [DOI] [PubMed] [Google Scholar]
  • 25.Siegel D. The influence of national guidelines on antihypertensive prescribing patterns. Curr Hypertens Rep. 2000;2:247–252. doi: 10.1007/s11906-000-0007-1. [DOI] [PubMed] [Google Scholar]
  • 26.Stokke H.P., Klemetsrud T., Westheim A., Tretli S., Olsen H. Prescription patterns of antihypertensive agents in general practice in 1995. Tidsskr Nor Laegeforen. 2000;120:1136–1140. [PubMed] [Google Scholar]
  • 27.Mateo C., Gil A., Sevillano M.L., Barutell L., Lorenzo A., Pérez de Lucas N. Calidad de la prescripción de antihipertensivos en un área de salud. Aten Primaria. 2000;25:302–307. doi: 10.1016/S0212-6567(00)78509-X. [DOI] [PMC free article] [PubMed] [Google Scholar]

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