Efectividad de la terapia combinada a dosis fijas en una cohorte de hipertensos no controlados con monoterapia

ObjetivoEvaluar la efectividad de lisinoprilhidroclorotiazida a dosis fijas en el control de la presión arterial en hipertensos tratados con monoterapia y mal controlados.DiseñoEstudio observacional, prospectivo.EmplazamientoAtención primaria.ParticipantesCiento noventa y nueve médicos de atención primaria que incluyeron a 931 pacientes (56,7% mujeres), con edad media de 62,0 ± 10,3 años. Finalizaron el estudio 915 pacientes (98%) que se incluyeron en el análisis.Mediciones principalesSe siguieron las recomendaciones de la OMS/SIH en la medición de la presión arterial y el diagnóstico de mal control. Además, se evaluaron presión del pulso, índice de masa corporal y parámetros analíticos básicos. Se realizaron 4 visitas durante 6 meses de seguimiento.ResultadosLisinopril-hidroclorotiazida (20/12,5mg) disminuyó significativamente la PAS (24,6 ± 3,5mmHg) y la PAD (14,3 ± 0,7mmHg) (p < 0,001). El control de la presión arterial aumentó hasta el 52,8% (p < 0,001). La edad fue la única variable que influyó en el control de la presión arterial (OR, 0,81; IC del 95%, 0,71-0,92%; p = 0,001). La presión del pulso disminuyó 10,4 ± 4,3mmHg (p < 0,001). A las 24 semanas de tratamiento, se observó una mejoría en el perfil glucémico y lipídico, y de la HbA1c en los diabéticos.ConclusionesEn atención primaria, lisinopril-hidroclorotiazida (20/12,5mg), controló la presión arterial del 52,8% los de hipertensos mal controlados con monoterapia. Además, disminuyó la presión del pulso y mejoró el perfil lipídico y el glucémico.ObjectiveTo evaluate the effectiveness of the fixed dose of a lisinoprilhydrochlorothiazide combination treatment in the control of blood pressure, in poorly controlled high blood pressure people, treated with monotherapy.DesignProspective observational study.SettingPrimary care frame.Participants931 patients (56.7% women) with an average age of 62.0±10.3 years, were included by 199 primary care physicians. 915 patients (98%) ended the study and finally they were included for the statistical analysis.Main measurementsOMS/SIH recommendations on blood pressure measurement and diagnose of poor control were followed. Pulse pressure, body mass index and basic clinical analyses were assessed. Four continuation visits were made during six months.ResultsLisinopril–hidrochlorothiazide (20/12.5mg) reduced significantly SBP (24.6±3.5mm Hg) and DBP (14,3±0.7mm Hg) (P<.001). Blood pressure control was only influenced by age (OR, 0.81; 95% CI, 0.71-0.92; P=.001). Pulse pressure was reduced in 10.4±4.3mm Hg (P<.001). After 24 weeks of treatment, glycemic and lipidic profiles showed an improvement, as well as HbA1c in diabetic people.ConclusionsIn Primary care, a 52.8% of poorly controlled with monotherapy high blood pressure people were controlled by a combination of lisinoprilhydrochlorothiazide (20/12.5mg). In addition, pulse pressure was decreased and both lipid and glucose blood profiles improved

OPENCRONIC Study. Knowledge and Experiences of Spanish Patients and Carers about Chronic Disease

Background: Chronic diseases are currently the main cause of morbidity and mortality and represent a major challenge to healthcare systems. The objective of this study is to know Spanish public opinion about chronic disease and how it affects their daily lives. Methods: Through a telephone or online survey of 24 questions, data was gathered on the characteristics of the respondents and their knowledge and experiences of chronic diseases. Results: Of the 2522 survey respondents, 325 had a chronic disease and were carers, 1088 had a chronic disease and were not carers, 140 did not have a chronic disease but were carers, and 969 did not have chronic disease and were not carers. The degree of knowledge on these diseases was good or very good for 69.4%, 56.0%, 62.2%, and 46.7%, respectively, for each group. All the groups agreed that chronic diseases mainly affect mood, quality of life and having to make sacrifices. Conclusions: Knowledge about chronic diseases is relatively good, although it can be improved among the Spanish population, especially among patients who report having a chronic disease and play the role of carers. However, it is important to continue maintaining the level of information and training concerning these diseases