Optimizing the treatment of hypertension in the primary care setting.

OBJECTIVE: To assess the result of the care provided by an interdisciplinary team on the control of hypertension. METHODS: In a Health Unit, 88 patients were treated by an interdisciplinary team for 12 months. Visits to the physician or nurse occurred every one to three months, and to the nutritionist whenever necessary. Educational lectures were delivered regularly. Total cholesterol and fasting plasma glucose levels were determined at baseline and at 12 months. Clinical and laboratory data were analyzed and blood pressure was compared at baseline and at six and 12 months, and total cholesterol and plasma glucose were compared at baseline and at 12 months. RESULTS: Females accounted for 79.41% of the sample and the mean age was 58+/-9.90 years. Median blood pressure (BP) was 166.00/96.5 mmHg at baseline, 146.75/85.25 mmHg at 6 months (p<0,000) and 134.00/80.00 mmHg at 12 months (p<0.000). The rate of BP< or =140/90 mmHg increased from 10.23% to 48.81% (p<0.000). Median total cholesterol decreased from 217 mg/dl to 194.00 mg/dl (p<0.004) and median blood glucose from 101 mg/dl to 95 mg/dl (NS). At baseline, 50% of the patients received two antihypertensive drugs, 25% received three, and 5.68% received four, whereas at 12 months these percentages were 21.18%, 29.41% and 32.94%, respectively. CONCLUSION: The care provided by an interdisciplinary team may significantly improve the control of hypertension and of associated cardiovascular risk factors.

Otimização de recursos no cuidado primário da hipertensão arterial / Optimizing the treatment of hypertension in the primary care setting

OBJETIVO: Avaliar o resultado da atuação de uma equipe interdisciplinar no controle da hipertensão. MÉTODOS: Numa Unidade de Saúde, 88 pacientes foram assistidos por uma equipe interdisciplinar, por 12 meses. As visitas ao médico e à enfermeira ocorreram cada um a três meses, e à nutricionista, quando necessário. Palestras educacionais foram ministradas, regularmente. O colesterol total e a glicemia de jejum foram medidos, na admissão e aos 12 meses do estudo. Foram analisados dados clínicos e laboratoriais e comparados à pressão arterial, na admissão e aos 6 e 12 meses do estudo, e o colesterol total e glicemia, na admissão e aos 12 meses. RESULTADOS: Havia 79,41 por cento de mulheres e a idade média era 58±9,90 anos. A mediana da pressão arterial foi 166,00/96,5 mmHg, na admissão, 146,75/85,25 mmHg, aos seis meses (p<0,000) e 134,00/80,00 mmHg aos 12 meses (p<0,000). A taxa de PA<140/90 mmHg subiu de 10,23 por cento para 48,81 por cento (p<0,000). A mediana do colesterol total diminuiu de 217 mg/dl para 194,00 mg/dl (p<0,004), e da glicemia, de 101 mg/dl para 95 mg/dl (NS). Na admissão, 50 por cento dos pacientes usavam dois anti-hipertensivos; 25 por cento, três; e 5,68 por cento, quatro; enquanto aos 12 meses esses percentuais passaram a 21,18 por cento, 29,41 por cento e 32,94 por cento, respectivamente. CONCLUSÃO: A assistência por equipe interdisciplinar pode melhorar, significativamente, o controle da hipertensão e de fatores de risco cardiovascular associados.

OBJECTIVE: To assess the result of the care provided by an interdisciplinary team on the control of hypertension. METHODS: In a Health Unit, 88 patients were treated by an interdisciplinary team for 12 months. Visits to the physician or nurse occurred every one to three months, and to the nutritionist whenever necessary. Educational lectures were delivered regularly. Total cholesterol and fasting plasma glucose levels were determined at baseline and at 12 months. Clinical and laboratory data were analyzed and blood pressure was compared at baseline and at six and 12 months, and total cholesterol and plasma glucose were compared at baseline and at 12 months. RESULTS: Females accounted for 79.41 percent of the sample and the mean age was 58±9.90 years. Median blood pressure (BP) was 166.00/96.5mmHg at baseline, 146.75/85.25mmHg at 6 months (p<0,000) and 134.00/80.00mmHg at 12 months (p<0.000). The rate of BP<140/90mmHg increased from 10.23 percent to 48.81 percent (p<0.000). Median total cholesterol decreased from 217mg/dl to 194.00mg/dl (p<0.004) and median blood glucose from 101mg/dl to 95mg/dl (NS). At baseline, 50 percent of the patients received two antihypertensive drugs, 25 percent received three, and 5.68 percent received four, whereas at 12 months these percentages were 21.18 percent, 29.41 percent and 32.94 percent, respectively. CONCLUSION: The care provided by an interdisciplinary team may significantly improve the control of hypertension and of associated cardiovascular risk factors.