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- W2004308635 abstract "La hipertensión arterial (HTA) afecta a la mayoría de la población muy anciana. El objetivo de este estudio fue estimar el grado de control de la HTA según se registre la presión arterial (PA) en la consulta o por monitorización ambulatoria de PA (MAPA). Estudio transversal y multicéntrico sobre pacientes hipertensos de 80 o más años de edad con tratamiento farmacológico antihipertensivo incluidos en el proyecto CARDIORISC–MAPAPRES. Entre junio de 2004 y abril de 2007 se obtuvo una base de datos de 33.829 registros de MAPA que cumplieron estándares de calidad preestablecidos. Se definió como buen control clínico a valores de PA menores de 140/90 mmHg, y como buen control ambulatorio a valores de PA por MAPA en período de 24 h menores de 130/80 mmHg. Se identificaron 2.311 pacientes (6,8%) de 80 o más años de edad. La edad media fue de 83,1 años (DE de 3,2) y un 63% fueron mujeres. El 21,5% (intervalo de confianza [IC] del 95%: 19,1–23,9) presentó buen control clínico y un 42,1% (IC del 95%: 39,7–45,3) presentó buen control ambulatorio (p<0,001). La prevalencia de HTA enmascarada fue del 7,0% (IC del 95%: 6,0–8,0) y la prevalencia de resistencia aislada en la clínica fue del 27,6% (IC del 95%: 25,7–29,4). La diabetes, la enfermedad renal crónica y la duración de la HTA fueron los factores más asociados al mal control de la HTA (p<0,001) en la MAPA de 24 h. Sólo 2 de cada 10 pacientes muy ancianos hipertensos tuvieron controlada adecuadamente su HTA por medida casual. Sin embargo, prácticamente el doble estaban controlados con el criterio de la MAPA. Estos hallazgos justifican un uso más amplio de la MAPA en el paciente hipertenso de edad muy avanzada. Hypertension is highly prevalent in the very elderly. We studied control rates of hypertension according to clinic blood pressure (BP) and ambulatory BP monitoring (ABPM) in treated hypertensives aged ≥80 years. Data came from the Spanish Society of Hypertension ABPM Registry (CARDIORISC – MAPAPRES project), which comprises a nation-wide network of more than 1,000 physicians sending standardized ABPM registries via web. Between June 2004 and April 2007 we obtained a 33.829-patient database. Control of hypertension was defined at the clinic when office BP was <140/90 mmHg and at the ABPM when mean BP during the 24-h period was <130/80 mmHg. We identified 2,311 patients (6.8%) aged ≥80 years. Mean age (SD) was 83.1 (3.2) years and 63% were women. Control of clinic BP was observed in 21.5% of cases (95%CI: 19.1–23.9) and control of 24-h BP in ABPM was 42.1% (95%CI: 39.7–45.3). Prevalence of masked hypertension was 7.0% (95%CI: 6.0–8.0) and prevalence of office-resistant control (white coat) was 27.6% (95% CI: 25.7–29.4). Diabetes, kidney disease, and duration of hypertension were associated with lack of control in ABPM. In very old hypertensives, control of clinic BP was 21.5% but ambulatory-based hypertension control was 42.1%. Physicians should be aware that the likelihood of misestimating BP control is high in these subjects. A wider use of ABPM in the elderly with hypertension should be considered." @default.
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- W2004308635 date "2009-11-01" @default.
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- W2004308635 title "Diferencias entre el control clínico y ambulatorio de la hipertensión arterial en pacientes muy ancianos. Proyecto CARDIORISC–MAPAPRES" @default.
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- W2004308635 doi "https://doi.org/10.1016/j.medcli.2009.04.056" @default.
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