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Advisor(s)
Abstract(s)
Objetivos:
Comparar características clínicas, de atividade médica e de caracterização familiar e social entre populações sofrendo de hipertensão arterial segundo estejam ou não controladas.
Metodologia
Estudo observacional em amostra aleatória por ordem alfabética e representativa com reposição em população de cuidados de saúde primários de 25 médicos especialistas em medicina geral e familiar de três unidades de cuidados de saúde primários no centro de Portugal, em 2018, pela análise dos registos clínicos informáticos das pessoas com a classificação ICPC‐2 de hipertensão arterial. Estudaram‐se variáveis epidemiológicas, clínicas, familiares, sociais e de atividade médica terapêutica. Realizou‐se estatística descritiva e inferencial.
Resultados
Num universo de 8750 pessoas com a classificação hipertensão arterial estudou‐se uma amostra de n = 387 (tamanho calculado para IC 95% e margem de erro de 5% em n = 369). Hipertensão arterial não controlada em 56,1% da amostra, significativamente mais frequente em quem vive só (p = 0,024), vive em família nuclear (p = 0,011), em situação de mais baixa classificação social (p = 0,018), com prescrição concomitante de AINE (p = 0,018). O risco cardiovascular calculado é não significativamente mais elevado no não controlo (p = 0,116). A inércia terapêutica não se verifica em número de associações e em número médio de medicamentos (p = 0,274) não se verificando igualmente diferença para as restantes variáveis estudadas. Viver só, pertencer a famílias com mais baixa classificação social e viver em família nuclear representam 9,6% da responsabilidade de não haver controlo.
Conclusões
A atividade médica no ambiente de medicina geral e familiar, e não só, deve assim aliar as competências terapêuticas com as habilidades de estudo individual e social para a melhoria do controlo da HTA em Portugal.
Objectives: To compare clinical characteristics, medical activity, and family and social charac-teristics of individuals with controlled and uncontrolled hypertension.Methods: This was an observational study on an alphabetically organized randomized sample ofindividuals suffering from hypertension in a primary care setting followed by 25 general practiti-oners at three clinics in the Central region of Portugal in mid-2018. Electronic medical records ofindividuals with an ICPC-2 classification of hypertension were analyzed. Epidemiologic, family,social and therapeutic data were gathered for descriptive and inferential analysis.Results: From a total population of 8750 patients classified as having hypertension, a repre-sentative sample of 387 individuals (n=369 required for a 95% confidence interval and 5% errormargin) was studied. The incidence of uncontrolled hypertension was 56.1%, significantly higheramong those living alone (p=00.24) or in a nuclear family (p=0.011), in lower socioeconomicclasses (p=0.018), and prescribed anti-inflammatory drugs (p=0.018). The calculated cardiovas-cular risk was no higher for uncontrolled hypertension (p=0.116). Therapeutic inertia was notfound either in number of medicines or in their association (p=0.274). No other studied varia-bles showed a significant difference. Binary logistic regression revealed that living alone or ina nuclear family, and in a family with low socioeconomic level, were associated with uncon-trolled hypertension, this model representing 9.6% of the likelihood of having uncontrolledhypertension.Conclusions: Medical activity in general practice and other settings should, in the light of thesefindings, ally therapeutic competencies with knowledge gained from studying individual, familyand social characteristics in order to improve blood pressure control.
Objectives: To compare clinical characteristics, medical activity, and family and social charac-teristics of individuals with controlled and uncontrolled hypertension.Methods: This was an observational study on an alphabetically organized randomized sample ofindividuals suffering from hypertension in a primary care setting followed by 25 general practiti-oners at three clinics in the Central region of Portugal in mid-2018. Electronic medical records ofindividuals with an ICPC-2 classification of hypertension were analyzed. Epidemiologic, family,social and therapeutic data were gathered for descriptive and inferential analysis.Results: From a total population of 8750 patients classified as having hypertension, a repre-sentative sample of 387 individuals (n=369 required for a 95% confidence interval and 5% errormargin) was studied. The incidence of uncontrolled hypertension was 56.1%, significantly higheramong those living alone (p=00.24) or in a nuclear family (p=0.011), in lower socioeconomicclasses (p=0.018), and prescribed anti-inflammatory drugs (p=0.018). The calculated cardiovas-cular risk was no higher for uncontrolled hypertension (p=0.116). Therapeutic inertia was notfound either in number of medicines or in their association (p=0.274). No other studied varia-bles showed a significant difference. Binary logistic regression revealed that living alone or ina nuclear family, and in a family with low socioeconomic level, were associated with uncon-trolled hypertension, this model representing 9.6% of the likelihood of having uncontrolledhypertension.Conclusions: Medical activity in general practice and other settings should, in the light of thesefindings, ally therapeutic competencies with knowledge gained from studying individual, familyand social characteristics in order to improve blood pressure control.
Description
Keywords
Hipertensão arterial Família Graffar Medicamento Risco Cardiovascular Controlo Anti-inflamatórios não esteroides
Citation
Martins RdS, et al. Pessoas que sofrem de hipertensão arterial: implicações na atividade médica das diferenças entre os controlados e os não controlados. Rev Port Cardiol. 2019.
Publisher
Elsevier España