• 作者：J.L. Llisterri Caro^a ; ^{jllisterric@medynet.com} ; G.C. Rodrí ; guez-Roca^b ; M.A. Perez Llamas^c ; V. Barrios Alonso^d ; P. Beato Ferná ; ndez^e ; T. Rama Martí ; nez^f ; C. Escobar Cervantes^g ; R. Genique Martí ; nez^h ; A. Garcí ; a Lerí ; nⁱ ; D. Gonzá ; lez-Segura^j ; en representació ; n del Grupo de Trabajo de Hipertensió ; n Arterial de la Sociedad Espa&ntilde ; ola de Mé ; dicos de Atenció ; n Primaria (Grupo HTA/SEMERGEN) y de los investigadores del Estudio PRESCAP 2006^&diams ;
• 关键词：Hipertensió ; n ; Diabetes ; Atenció ; n Primaria ; Espa&ntilde ; a
• 刊名：SEMERGEN - Medicina de Familia
• 出版年：2010
• 期刊代码：pca342_11383593
• 类别：med
• 出版时间：June-July 2010
• 卷：36
• 期：6
• 页码：307-316
• 文件大小：306 K

Objectives

To know the grade of blood pressure (BP) control in a large sample of diabetic hypertensive patients attended in Primary Care (PC) and to determine the factors associated to poor blood pressure control.

Material and methods

A cross-sectional and multicenter study that included diabetic hypertensive subjects of 18 years or older, recruited by consecutive sampling by family doctors throughout Spain. The measurement of BP was performed following standardized guidelines, calculating the arithmetic mean of at least two successive measurements separated by two minutes. Good control of arterial hypertension (AHT) was considered to be the average of BP lower than 140/90 mmHg as recommended by the European Society Hypertension (ESH 2009). The percentage of patients with BP below 130/80 mmHg (ESH 2007 and American Diabetes Association 2010) was also evaluated. Socio-demographic, clinical data, cardiovascular risk factors, associated clinical disorders and drug treatments were also recorded.

Results

A total of 2752 patients (55.6%women) with a mean (SD) age of 67.1 (9.8) years were included. Of these, 64.3%presented dyslipidemia, 61.8%sedentary life style, 46.5%obesity, 41.2%background of cardiovascular disease and 16.0%smoked. A total of 66.1%received combined therapy (two drugs 43.5%, three 17.9%and four or more 4.7%). Following the 2009 recommendations, 47.3%(95%CI: 45.4鈥?9.2) had good control of the systolic BP (SBP) and diastolic BP (DBP), 50.2%(95%CI: 48.3鈥?2.1) only of the SBP and 79.8%(95%CI: 78.3鈥?1.3) only of DBP. Considering the 2007 criteria, 15.1%(95%CI: 13.8鈥?6.4) showed good control of SBP and DBP, 22.5%(95%CI: 20.9鈥?4.1) of SBP and 38.2%(95%CI: 36.4鈥?0.0) of DBP. Obesity, sedentary life, and not having taken the medication on the day of the visit were the factors that were most associated to the poor control of AHT (Wald 蠂²; p<0.01).

Conclusions

The results of the PRESCAP-Diabetes study indicate that BP is well-controlled in almost half of the diabetic hypertensive subjects attended in PC. We have found important differences in the grade of control according to the objectives recommended in 2007 or 2009.