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      Cumplimiento del tratamiento farmacológico y control de la presión arterial en pacientes del programa de hipertensión: Hospital Víctor Lazarte Echegaray - EsSALUD, Trujillo

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          Abstract

          Objetivo: Determinar si el tratamiento farmacológico es óptimo en cumplimiento y en el control de los valores de presión arterial en los pacientes del Programa de Hipertensión del Hospital Víctor Lazarte Echegaray. Material y métodos: Se realizó un estudio transversal aleatorio en 81 pacientes en consultorio externo del programa. Resultados: Cuarenta y siete (58%) de los pacientes cumplen con las indicaciones y 58 (71.6%) de los pacientes acude regularmente a las citas. No encontramos relación significativa entre cumplimiento y variables como grado de instrucción y el uso de monoterapia o asociaciones de antihipertensivos. Las razones para el incumplimiento señaladas por los pacientes fueron: No supo u olvidó las recomendaciones (55.9%), se le agotaron los medicamentos que le suministra el programa 38.2%), sensación de mejoría experimentada (2.9%) y efectos colaterales (2.9%). Cuarentaitres pacientes (53.8%) tuvieron controles de presión arterial adecuadas. Se encontró relación significativa entre un control adecuado de presión arterial y el cumplimiento del tratamiento farmacológico antihipertensivo así como con estadios I o II de hipertensión arterial. Conclusiones: La principal razón señalada por los pacientes del incumplimiento del tratamiento fue el olvido de las indicaciones del médico. Se encontró relación directa entre control adecuado de los niveles de presión arterial y cumplimiento del tratamiento así como con estadios I ó II de hipertensión arterial. (Rev Med Hered 2001; 12:120-126).

          Translated abstract

          Objective: A randomized transversal study was carried out for to determine if the pharmacology treatment compliance is adequate in patients of Hypertension Program from Hospital Victor Lazarte Echegaray. Material and methods: 81 patientes were included for a questionnaire. Medical indications were fulfilled by 45 (58%) patients. There was not associations with variables: Instruction degree and use of monoterapia or hypertensive drug associations. The reasons for don’t compliance treatment were: Forgot indications (55.9%), deplete medictions given for the program (38.2%), feeling of improvement (2.9%) and side effects (2.9%). 43 patients (53.8%) had controlled arterial pressure. There was associations between adequate levels of blood pressure and compliance of pharmacology antihypertensive treatment and associations between adequate levels and I and II stages of hypertension. Conclusions: The first reason for don’t compliance treatment was: patients forgot indications. There is relation between adequate levels of blood pressure and I and II stages of hypertension. (Rev Med Hered 2001; 12: 120-126 ).

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          Control of blood pressure in Scotland: the rule of halves.

          Audit of detection, treatment, and control of hypertension in adults in Scotland. Cross sectional survey with random population sampling. General practice centres in 22 Scottish districts. 5123 Men and 5236 women aged 40-59 in the Scottish heart health study, randomly selected from 22 districts throughout Scotland, of whom 1262 men and 1061 women had hypertension (defined as receiving antihypertensive treatment or with blood pressure above defined cut off points). Hypertension (assessed by standardised recording, questionnaire on diagnosis, and antihypertensive drug treatment) according to criteria of the World Health Organisation (receiving antihypertensive treatment or blood pressure greater than or equal to 160/95 mm Hg, or both) and to modified criteria of the British Hypertension Society. In half the men with blood pressure greater than or equal to 160/95 mm Hg hypertension was undetected (670/1262, 53%), in half of those in whom it had been detected it was untreated (250/592, 42%), and in half of those receiving treatment it was not controlled (172/342, 50%). In women the numbers were: 486/1061, 46%; 188/575, 33%; and 155/387, 40% respectively. Assessment of blood pressure according to the British Hypertension Society's recommendations showed an improvement, but in only a quarter of men and 42% of women was hypertension detected and treated satisfactorily (142/561, 215/514 respectively). The detection and control of hypertension in Scotland is unsatisfactory, affecting management of this and other conditions, such as high blood cholesterol concentration, whose measurement is opportunistic and selective and depends on recognition of other risk factors.
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            Blood-pressure control in the hypertensive population.

            In large-scale surveys of individuals with hypertension those whose clinic blood pressure is reduced to 140/90 mm Hg or less have been found to represent only a small fraction of the hypertensive population. We assessed whether these results arise because of a white-coat effect elevating clinic blood pressure. We randomly selected 2400 individuals from the town of Monza, Italy, and invited them to take part in our study. We measured clinic blood pressure as well as home (morning and evening measurements), and 24 h ambulatory blood pressure-ie, blood pressures largely devoid of a white-coat effect. Based on clinic blood pressure participants were then classified as normotensive, untreated hypertensive (clinic blood pressure > 140 mm Hg systolic and/or > 90 mm Hg diastolic), or treated hypertensive (having antihypertensive treatment). The mean blood pressures for each group were calculated. 1651 people took part in the study. The clinic blood pressure of treated hypertensives (n = 207; 146.9 [SD 18] mm Hg/90.2 [8.6] mm Hg) was only slightly less than in untreated hypertensives (n = 402; 148 [15.2] mm Hg/93.3 [8] mm Hg) and in both groups the blood pressure values were much greater than those of normotensive individuals (n = 1042; 119.5 [10.3] mm Hg/78.1 [6.6] mm Hg) p < 0.001. Averaged home and 24 h blood pressures were lower than clinic blood pressures but similarly higher in untreated and treated hypertensive individuals when compared with normotensive individuals. This was also the case for day and night average blood pressures. The number of treated hypertensive patients found to have blood pressures within the normal limits was small not only when based on clinic blood pressure values but also when based on ambulatory blood-pressure values. In the hypertensive population the number of patients with inadequate blood-pressure control is high not only when assessed in the clinic but also when assessed by ambulatory-blood-pressure monitoring or at home. The high blood-pressure values commonly found in treated hypertensive individuals cannot be accounted for by a white-coat effect but by a true lack of daily-life blood-pressure control.
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              Compliance in hypertension: facts and concepts.

              The management of hypertension is still far from optimal, although safe and effective drugs are available and the effectiveness of antihypertensive therapy in reducing cardiovascular morbidity is well established. Today, low patient compliance is one of the most important therapy-limiting factors in hypertension. Although patient care seems to have improved, possibly due to increased knowledge about patient compliance in recent years, 10-15% of hypertensives are still lost from follow-up in the first year of therapy, and 20-40% of patients comply insufficiently with prescribed antihypertensive therapy. In this article the magnitude of the problem of drop-outs and non-compliance with medication, the determinants of compliance in hypertension, and the models used to understand patients' health behaviour are reviewed.
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                Author and article information

                Journal
                rmh
                Revista Medica Herediana
                Rev Med Hered
                Universidad Peruana Cayetano Heredia. Facultad de Medicina "Alberto Hurtado" (Lima, , Peru )
                1018-130X
                1729-214X
                October 2001
                : 12
                : 4
                : 120-126
                Affiliations
                [02] orgnameEsSalud-Trujillo orgdiv1Hospital Víctor Lazarte Echegaray
                [01] orgnameEsSalud-Chiclayo orgdiv1Hospital Nacional Almanzor Aguinaga Asenjo
                Article
                S1018-130X2001000400003 S1018-130X(01)01200403
                1fd0a4b7-52f5-44d5-b6d8-2a2ea97baed1

                http://creativecommons.org/licenses/by/4.0/

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                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 28, Pages: 7
                Product

                SciELO Peru

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                Artículos originales

                compliance,Hypertension,tratamiento,cumplimiento,Hipertensión,treatment

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