Conducta del médico de atención primaria ante el mal control de la hipertensión arterial. Estudio PRESCAP 2010
- Alonso Moreno, Francisco Javier
- Llisterri Caro, José Luis
- Rodríguez Roca, Gustavo C.
- Prieto Díaz, Miguel Ángel
- Divisón Garrote, Juan Antonio
- Barrios Alonso, Vivencio
- Santos Altozano, Carlos
- Ferreiro Madueño, Manuel
- Banegas Banegas, José Ramón
- González-Segura Alsina, Diego
ISSN: 1138-3593
Año de publicación: 2013
Número: 1
Páginas: 3-11
Tipo: Artículo
Otras publicaciones en: Semergen: revista española de medicina de familia
Objetivos de desarrollo sostenible
Resumen
Introduction: There is a need for more information on therapeutic inertia in blood pressure (BP) treatment. The purpose of this study was to determine the therapeutic behaviour and associated factors of Primary Care (PC) physicians on uncontrolled hypertensive patients. Patients and methods: Cross-sectional multicentre study of patients with hypertension attending Spanish PC centres. Data was collected from patients (social-demographics, clinical status and treatment), as well as data from physicians (medical practice, background and therapeutic behaviour) were collected. Uncontrolled BP was considered when average BP values where =140/90 mmHg. Results: A total of 12,961 patients (52.0% women) were included. The mean age was 66.3 (SD 11.4) years, and mean number of years from diagnosis of hypertension was 9.1 (6.7) years. Almost two-thirds (62.4%) of the patients were taking a combined blood pressure treatment, (44.2% with two drugs and 18.2% with three drugs, or more). An uncontrolled BP was observed in 38.9% (95% CI: 38.1-39.7) of patients. Treatment was changed by physicians in 41.8% (95% CI: 40.4-43.2) out of 5,036 uncontrolled patients. Adding another drug was the most frequent behaviour (55.6%). The physician¿s perception of good BP control in uncontrolled patients, together with the presence of combined blood pressure treatment, were the two variables most strongly associated with therapeutic inertia. Conclusions: The Spanish PC Physician modified antihypertensive treatment in only 4 out of 10 uncontrolled patients. The physician's perception of good BP control was the variable most strongly associated with therapeutic inertia.