Perfil metabólico y deterioro de órganos diana en hipertensos esenciales según el control de la presión arterial en la consulta

Abstract

To evaluate the degree of metabolic control and end-organ damage in a group of hypertensive patients with poor and good blood pressure (BP) control in primary health care centers. Observational study with diagnostic intervention, performed in 16 primary care centers of Burgos (Spain). 207 patients (120 with good BP control and 87 with poor BP control) with pharmacological treatment were included in the study. The following parameters were determined: clinic history, casual BP, 24-h ambulatory blood pressure monitoring (ABPM), electrocardiography, and clinic analysis in plasma and 24-hour urine. The 32% and 31% of patients respectively were receiving combined pharmacological treatment. No significant differences were detected between the two groups for the levels of c-HDL > 130 mg/dl (62% vs. 62%), microalbuminuria (5% vs. 10%) and basal glucose levels > 126 mg/dl (105 vs. 15%). There was a significant proportion of patients with poor clinical BP control with left ventricular hypertrophy (13% vs. 34%; p < 0,001), impaired renal function (3% vs. 11%; p < 0,05), mean hematocrit value (41,9 +/- 4,5 vs. 43,7 +/- 3,5; p < 0,01) and different degree on BP control by ABPM (1,6% vs. 16%: p < 0,01). Our hypertensive patients with poor BP clinical control showed more end-organ damage than those with good control, although they have a similar metabolic profile. The access to ABPM by primary health care centers could modify the therapeutic management in a significant subgroup of hypertensive patients with poor BP control.