Knowledge, availability, and use of ambulatory and home blood pressure monitoring in primary care in Spain: the MAMPA study.

OBJECTIVE: To examine the degree of knowledge and management of automated devices for office blood pressure measurement (AD), home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM) in primary care in Spain. METHODS: Online self-administered survey sent between May 2016 and February 2017 to 2221 primary-care physicians working across Spain. Clinicians were mostly identified through national primary-care scientific societies (20% overall response rate). RESULTS: Participants' mean age was 47.7 years, 55% were women, and 54% reported at least 20 years of primary-care practice. Among them, 47.5% considered ABPM the best diagnostic method for hypertension, 23% chose HBPM, and 7.1% chose office blood pressure. Also, 78.2% had AD available at their centers and 49.0% had ABPM, with slight urban/rural differences. HBPM was recommended in daily practice for hypertension diagnosis by 67% of participants, whereas 30% recommended ABPM. Cost to the patients was the main reason for not using HBPM (42.7%) as was lack of accessibility for not using ABPM (69.8%). Lack of specific training was also reported as an important reason in both cases. CONCLUSION: Even in the possibly best primary care scenario presented by highly motivated physicians (respondents to a voluntary anonymous survey), enormous gaps were observed between current guidelines' recommendations on ABPM and HBPM use for confirming hypertension and the modest degree of knowledge, availability, and use of these technologies.

[Knowledge level of hypertensive patients about hypertension. Relationship between knowledge level and hypertension control]. / Estudio Conocimiento: grado de conocimiento sobre hipertensión arterial de nuestros pacientes. Relación con el nivel de control de la misma.

OBJECTIVE: To assess the knowledge of the hypertensive patients about their hypertension and their relation to its control. MATERIAL AND METHODS: Cross-sectional study among 400 hypertensive patients, all over 18 years, selected from 50 primary-care centres, who responded to an hypertension-related survey. Included variables were survey items, age, gender, educational level, professional occupation, blood pressure data and antihypertensive treatment. The obtained differences were analyzed using the chi-square test, Kruskal-Wallis, Wilcoxon, Anova and Bonferroni methods. RESULTS: There were 323 valid surveys. 52.9% of respondents were women, the average age: 65.4 years (SD: 11.2), 54.8% of them had primary education. 39.6% were aware of the objectives of systolic BP control. Only 19.6% having knowledge of those for diastolic BP control, with no differences between controlled and uncontrolled (systolic BP: 39% vs 38.1%, P=.887; diastolic BP: 19.2% vs 21%, P=.721). Over 70% knew about lifestyle changes, without significant differences between controlled and uncontrolled respondents. 82% of controlled respondents, and 79% of those uncontrolled, recognized the chronical nature of the treatment (P=.548), but 15.1% of the controlled respondents and 12.4% of uncontrolled respondents did not see the relation between the treatment and hypertension control (P=.525). 31.1% believed to be well-controlled, but in fact was not. CONCLUSIONS: Our patients doesn't know blood pressure targets of control. There isn't relationship between this knowledge and control of hypertension.

Estudio Conocimiento: grado de conocimiento sobre hipertensión arterial de nuestros pacientes. Relación con el nivel de control de la misma / Knowledge level of hypertensive patients about hypertension. Relationship between knowledge level and hypertension control

Objetivo: Evaluar el conocimiento de nuestros pacientes hipertensos sobre su HTA y su relación con el control de la misma. Material y métodos: Estudio descriptivo transversal con 400 hipertensos, mayores de edad, seleccionados de forma sistemática consecutiva de 50 consultas de atención primaria, que respondieron una encuesta sobre HTA. Las variables recogidas fueron los ítems de la encuesta, edad, sexo, nivel educacional, ocupación, cifras de presión arterial y tratamiento antihipertensivo. Las diferencias se analizaron con los test ji-cuadrado, Kruskal-Wallis, Wilcoxon, Anova y Bonferroni según distribución normal. Resultados: Fueron válidas 323 encuestas. El 52,9% fueron mujeres, edad media de 65,4años (DE: 11,2). El 54,8% contaban con estudios primarios. El 39,6% conocían los objetivos de control de PA sistólica, y solo el 19,6% los de PA diastólica, sin diferencias entre controlados y no controlados (PA sistólica: 39% vs 38,1%, p = 0,887; PA diastólica: 19,2% vs 21%, p = 0,721). Más del 70% conocían las modificaciones del estilo de vida, sin diferencias entre controlados y no controlados. El 82% de los controlados y el 79% de los no controlados reconocieron la cronicidad del tratamiento (p = 0,548), pero el 15,1% de los controlados y el 12,4% de los no controlados no lo relacionaban con el control de la HTA (p = 0,525). El 31,1% creían estar bien controlados aunque no lo estaban. Conclusiones: Los pacientes hipertensos conocen en baja frecuencia cuáles son los objetivos de control, sin encontrar relación entre el conocimiento del problema y el control del mismo

Objective: To assess the knowledge of the hypertensive patients about their hypertension and their relation to its control. Material and methods: Cross-sectional study among 400 hypertensive patients, all over 18 years, selected from 50 primary-care centres, who responded to an hypertension-related survey. Included variables were survey items, age, gender, educational level, professional occupation, blood pressure data and antihypertensive treatment. The obtained differences were analyzed using the chi-square test, Kruskal-Wallis, Wilcoxon, Anova and Bonferroni methods. Results: There were 323 valid surveys. 52.9% of respondents were women, the average age: 65.4 years (SD: 11.2), 54.8% of them had primary education. 39.6% were aware of the objectives of systolic BP control. Only 19.6% having knowledge of those for diastolic BP control, with no differences between controlled and uncontrolled (systolic BP: 39% vs 38.1%, P = .887; diastolic BP: 19.2% vs 21%, P = .721). Over 70% knew about lifestyle changes, without significant differences between controlled and uncontrolled respondents. 82% of controlled respondents, and 79% of those uncontrolled, recognized the chronical nature of the treatment (P = .548), but 15.1% of the controlled respondents and 12.4% of uncontrolled respondents did not see the relation between the treatment and hypertension control (P = .525). 31.1% believed to be well-controlled, but in fact was not. Conclusions: Our patients doesn’t know blood pressure targets of control. There isn’t relationship between this knowledge and control of hypertension