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Vol. 200. Issue 8.
Pages 407-411 (August 2000)
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Vol. 200. Issue 8.
Pages 407-411 (August 2000)
El control de la hipertensión arterial mediante monoterapia farmacológica en Atención Primaria
Control of primary hypertension by pharmacologic monotherapy in Primary Care
G.J. Díaz Grávalos****
Corresponding author
gpalmeirof@papps.org

Correspondencia: G. J. Díaz Grávalos. Feria, 9. 32130 Cea (Ourense)
, G. Palmeiro Fernández
I. Casado Górriz*, M.J. González Bouzo*, J.L. Romero Limia**, D. Valiño López***, X.A. Ricoy Lago***
* Centro de Salud Cea, EAP Allariz. Ourense
** Centro de Salud Cea and Castrelo do Val. Ourense
*** Centro de Salud Cea, EAP O Barco. Ourense
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Fundamento

Analizar el grado de control de la presión arterial (PA) conseguido con monoterapia y las características de la misma.

Sujetos y métodos

Se obtuvo una muestra de 277 hipertensos (83 varones y 194 mujeres) en tratamiento con monoterapia a partir de un muestreo en conglomerados. Todos los pacientes incluidos eran mayores de 18 años y presentaban hipertensión arterial esencial (HTA). Se registraron PA sistólica y diastólica (media de dos tomas), fármaco, edad y sexo.

Resultados

Menos del 30% de los sujetos presentaban control adecuado (<140/90 mmHg), fundamentalmente por mal control de la PA sistólica. El grupo farmacológico más usado era el de los inhibidores de la enzima convertidora de la angiotensina (IECA), seguido de los bloqueadores del calcio (BCA), siendo las sustancias más prescritas enalapril y clortalidona. Los diuréticos (DIU) se usaban más en mujeres (OR 4,2). El uso de DIU, BCA y bloqueadores alfaadrenérgicos se incrementaba con la edad, al contrario que IECA y bloqueadores beta.

Conclusiones

Se constata un mal resultado en el control de la HTA en pacientes tratados con monoterapia, especialmente para el componente sistólico. Hay un mayor uso de IECA y BCA. Existe una diferencia muy significativa en el uso de diuréticos entre varones y mujeres que no tiene justificación teórica.

Palabras Clave:
hipertensión
monoterapia
Atención Primaria
Objective

To analyze the control degree and characteristics of arterial pressure (AP) obtained with monotherapy.

Subjects and methods

A sample was obtained of 277 hypertensive patients (83 men and 194 women) on monotherapy from cluster sampling. All included patients were older than 18 years and had essential hypertension (HBP). Both systolic and diastolic pressure values (mean of two measurements), prescribed drug, age and sex were recorded.

Results

Less than 30% of subjects had adequate control (< 140/90), mainly because of poor control of systolic BP. The drug group most commonly was ACEI, followed by calcium blockers (CAB); enalapril and chlortalidone were the most commonly prescribed drugs. Diuretics were used most frequently by women (OR 4.2). The use of diuretics, calcium channel antagonists and alphaadrenergic blockers increased with age. The opposite was true for ACEI and beta blockers.

Conclusions

A poor control of HBP in patients on monotherapy was observed, particularly for the systolic component. There is a higher use of ACEI and HBP. There is a highly significant difference regarding the use of diuretics between men and women which has no theoretical basis.

Key Words:
Hypertension
monotherapy
Primary Care

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