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[Control of arterial pressure: experience at a hospital monographic unit arterial hypertension]
J Segura de la Morena1, C Campo Sien, M L Fernández López
1Unidad de Hipertensión Arterial, Servicio de Nefrología, Hospital 12 de Octubre, Ctra. de Andalucía, km. 5,400, 28041 Madrid. jsegurad@senefro.org
Insights
Over twenty years, referred hypertensive patients became younger and heavier, with less severe blood pressure. Improved control resulted from new antihypertensive drugs and combination therapies.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Trials
Context:
- Analysis of 4,103 patients referred for hypertension study between 1977 and 1997.
- Evaluation of demographic and clinical characteristics, including age, weight, systolic blood pressure (SBP), and diastolic blood pressure (DBP).
Purpose:
- To analyze the evolution of blood pressure control in referred hypertensive patients.
- To assess changes in patient characteristics and therapeutic guidelines over two decades.
Summary:
- Hypertensive patients referred for study decreased in mean age (males: 67 to 56; females: 68 to 52) and increased in mean weight (males: 71 to 81 kg; females: 69 to 73 kg).
- Basal SBP/DBP decreased significantly in both males (176/112 to 154/94 mmHg) and females (182/105 to 154/93 mmHg).
- Antihypertensive drug use shifted from single/no drug (62%) to multiple drugs (64%) over the study period.
Impact:
- Demonstrates a trend towards younger, heavier patients with less severe hypertension.
- Highlights the effectiveness of modern antihypertensive pharmacotherapy and combination treatments in improving blood pressure control.
Objective:
To analyse the evolution of blood pressure control in patients referred to our centre for study, proportion of controlled hypertensive patients, changes in the characteristics of hypertensive patients and in therapeutic guidelines in the last twenty years.
Material And Methods:
A total of 4,103 patients were referred to study of hypertension. The analysed variables year by year included sex, age, weight, systolic blood pressure (SBP) and diastolic blood pressure (DBP). Cross sections at five-year intervals were performed to collect basal SBP and DBP and the evolution of BP in the following five years.
Results:
From 1977 to 1997 the following changes were observed: basal mean age changed from 67 +/- 9 down to 56 +/- 10 years among males and from 68 +/- 8 down to 52 +/- 9 years among females; basal mean weight changed from 71 +/- 7 up to 81 +/- 8 kg among males and from 69 +/- 12 up to 73 +/- 13 years among females. Males showed a decrease in basal mean values of SBP/DBP from 176 +/- 25/112 +/- 20 mmHg down to 154 +/- 21/94 +/- 12 mmHg. In women, the corresponding values changed from 182 +/- 36/105 +/- 19 mmHg down to and 154 +/- 23/93 +/- 12 mmHg. In the early 1980's, 62% of patients received one or no antihypertensive drug. In the last few years such percentage has been 36% and 64% have been treated with two or more drugs.
Conclusions:
A decrease in age and an increase in weight of hypertensive patients referred to study have been observed in the last twenty years. Such patients show a less severe hypertension compared with referred patients in the early years. The use of new hypertensive drugs and their combined use are measures that contribute to improve the percentage of controlled hypertensive patients.