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Revista chilena de cardiología

versión On-line ISSN 0718-8560

Resumen

CHACON, Javier; SANDOVAL, Daniela; MUNOZ, Reinaldo  y  ROMERO, Tomás. Assessment of blood pressure control and adherence in hypertensive patients followed in the Cardiovascular Health Program (CHP): Association with clinical, socioeconomic and psychosocial characteristics. Rev Chil Cardiol [online]. 2015, vol.34, n.1, pp.18-27. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602015000100002.

Background:    Unsatisfactory    blood    pressure (BP) control and low adherence to antihypertensive pharmacotherapy (Rx) in hypertensive populations are persistent problems worldwide and also in Chile. Socioeconomic and psychosocial factors have been frequently mentioned, but with limited contributions from Chile. Objective: The assessment of BP control and adherence to Rx in hypertensive patients followed in the Cardiovascular Health Program (CVHP) and to determine their association with clinical, socioeconomic and psychosocial characteristics. Methods: A randomized sample of 1,794 hypertensive patients followed for 1 year under the CVHP in Metropolitan Region. Association of BP control (<140/90 mmHg) and adherence with age, gender, education, income, Rx, diabetes, obesity, smoking, alcohol use problem and physical activity were analyzed. In a subgroup of 600 patients additional analysis included the association with emotional stress and depression, patient-physician relation and social support. Odds Ratio (OR) were obtained by multivariate logistic regression. Results: BP control was achieved in 56.5% and adherence in 37.3%. No association was found between them (OR 1.01 [CI 95% 0.78-1.32]). Uncontrolled BP and no adherence were associated to advanced age, low income, poor patient-physician relation and high stress-depression. Obesity and multiple Rx were associated to uncontrolled BP. Male gender and low education, were associated to no adherence. Conclusions: BP control (56.5%) was similar to results obtained in developed countries and is strikingly higher than the results reported in the 2010 Chilean National Health Survey (16.9%). These results and the lack of association between BP control and adherence suggest the favorable influence of unaccounted factors, possibly related to the CVHP.

Palabras clave : Hypertension; blood pressure control; adherence to medication.

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