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[Changes in hypertensive control 2020-2021 in a family medicine unit]
Daniel Tetetla-Castro1, Guiomar de Jesús Cruz-Martín2, Angélica Castro-Ríos3
1Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 39, Servicio de Medicina Familiar. Villahermosa, Tabasco, México.
Insights
The COVID-19 pandemic significantly worsened high blood pressure control, with a 29.1% decrease in patients meeting therapeutic goals. Type 2 diabetes emerged as a major risk factor, nearly doubling its impact on hypertension management.
Area of Science:
- Cardiovascular Medicine
- Public Health
- Epidemiology
Background:
- High blood pressure is a leading global cause of mortality, responsible for 9.4 million deaths annually.
- The COVID-19 pandemic necessitated changes in patient care, impacting chronic disease management.
- Hypertension control is critical for preventing cardiovascular events and mortality.
Purpose of the Study:
- To assess the impact of the COVID-19 pandemic on hypertensive control in patients at UMF 18 of Tabasco.
- To compare blood pressure control rates before and after the pandemic's onset.
- To identify factors associated with changes in hypertensive control.
Main Methods:
- A retrospective longitudinal observational study was conducted.
- A random sample of 326 patients diagnosed with hypertension was analyzed.
- Blood pressure, comorbidities (dyslipidemia, diabetes), and sociodemographic data were collected and analyzed using multinomial regression.
Main Results:
- Hypertensive control decreased significantly from 79.1% in 2020 to 50% in 2021, a 29.1% decline.
- Type 2 diabetes comorbidity was identified as the most significant risk factor for poor hypertensive control, with its effect nearly doubling post-pandemic.
- The economically active population faced greater challenges in achieving therapeutic blood pressure goals.
Conclusions:
- The COVID-19 pandemic led to a substantial reduction in effective hypertension management.
- Type 2 diabetes poses a heightened risk for uncontrolled blood pressure, especially during public health crises.
- Targeted interventions are needed for vulnerable groups, such as the economically active population, to improve hypertension control.
Background:
High blood pressure causes 9.4 million deaths worldwide annually (12.8% of total mortality). With the start of the COVID-19 pandemic and containment measures, the patterns of care for these patients changed.
Objective:
To evaluate the changes in hypertensive control of patients treated at UMF 18 of Tabasco before and after the appearance of COVID-19.
Material And Methods:
Retrospective longitudinal observational study that included a random sample of 326 patients. Hypertensive control was evaluated in accordance with the current Clinical Practice Guideline. Information was collected on blood pressure, dyslipidemia, and glycated hemoglobin for diabetics, as well as other clinical variables and sociodemographic information. The proportion of patients who remained in hypertensive control, worsened or never remained in control was compared between the two periods. Associated factors were identified through multinomial regression analysis.
Results:
Before the pandemic, in 2020, 79.1% of patients had blood pressure levels under control, by 2021 it dropped to 50%. T2 diabetes comorbidity was the most important risk factor for lack of control, which after the appearance of COVID-19 almost doubled its effect.
Conclusions:
A decrease of 29.1% was recorded in compliance with hypertensive control. Groups with greater difficulty in achieving therapeutic goals were identified, highlighting the economically active population.
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