Control de la hipertensión arterial basado en la automedición ambulatoria de la presión arterial: Estudio APACHE

Abstract

The objective was to analyze the control rates of hypertension in a large group of hypertensives on antihypertensive treatment by means of blood pressure (BP) self-measurements, and to assess if the degree of control at early morning hours differs from that at the rest of the day. 9,227 subjects [4,398 men, mean age 61.0 (11.4) yr, body mass index 28.4 (4.1) kg/m2] who had hypertension and were on antihypertensive treatment at least during one month before were included. Patients were recruited from primary care physicians. After receiving training, six BP measurements over one day were performed by means of a Braun Precision Sensor BP 2550 monitor, which measures BP at wrist level. Whole day SBP and DBP averages were 138.4 (16.5) mmHg and 85.4 (8.7) mmHg, respectively. Both SBP and DBP in early morning hours were significantly higher than those observed before lunch or before dinner. The percentage of subjects with BP < 130/80 mmHg was 15.5%; 15.4% had SBP < 130 mmHg but DBP > 80 mmHg, and 2.0% had DBP < 80 mmHg and SBP > 130 mmHg). Control rates were lower at early morning hours and in men. By using BP self-measurement, control rates of hypertension are low, especially in early morning hours as compared to the rest of the day. New strategies are needed to further increase the control of hypertension.