[Analysis of arterial pressure variability among individuals with white coat hypertension and essential arterial hypertension using blood pressure ambulatory monitoring]. / Análisis de la variabilidad de la presión arterial entre individuos con hipertensión de bata blanca e hipertensión arterial esencial mediante monitorización ambulatoria de la presión arterial.

OBJECTIVES: To compare patients with "white coat" hypertension (WCH) and essential hypertension for variability in blood pressure (BP) taken in the clinic. DESIGN: Crossover study. SETTING: La Orden Health Centre, Huelva. PATIENTS: 126 people with light-to-moderate hypertension, de novo or not, being monitored but not treated by drugs. Two groups were formed: WCH defined by mean daily systolic and distolic pressures below 135 and 85 mmHg, and hypertension when the BP was over 140 and/or 90 mmHg. MEASUREMENTS AND MAIN RESULTS: BP was taken in the clinic in two periods: by day (7 a.m. to midnight) and at night (00.01 to 06.59), with readings every 15 and 30 minutes, respectively. Variability was compared by analysing: a) variability indices (VI), and b) coefficients of variation (CV) in BP. A regression test and multiple correlation was used. Both groups (hypertension and WCH) contained 63 people (average age: 53.4 +/- 10 and 50 +/- 10). No significant differences between the two groups in the VI were observed, except greater variability in the VI of the nocturnal systolic pressure of the hypertension group. The CV was higher in the WCH group for all pressures, with differences for 24-hour and day-time systolic pressure. The VI of systolic pressure correlated significantly with its overall clinical systolic pressure in the 24-hour period, with the day and night-time readings and with age in the day-time period. CONCLUSIONS: Variability in the blood pressure of people with essential hypertension and WCH does not differ. Variability in systolic pressure shows positive correlation with clinical systolic pressure and, to a lesser extent, with age.

[Therapeutic compliance in dyslipidemias. A trial of the efficacy of health education]. / Cumplimiento terapéutico de las dislipemias. Ensayo sobre la eficacia de la educación sanitaria.

OBJECTIVE: To analyse the efficacy of health education (HE) through group session with postal back-up in furthering compliance with therapy for Lipaemia. DESIGN: Controlled clinical trial, with random distribution. SETTING: Primary care. PATIENTS: 110 patients with Hypercholesterolaemia, with new diagnoses or not in treatment, in which medical treatment with statins was indicated as a start or change in medication. INTERVENTIONS: They were distributed in two groups at random, with observation four months after being included in the study and appointments after one, two and four months. 1. Control group (CG): 55 patients who received HE from their family doctor. 2. Intervention group (IG): 55 patients whose HE was monitored: a) a group HE session and b) back-up by letter sent to their homes. MEASUREMENTS AND RESULTS: Patients whose consumption was between 80 and 110% of the amount prescribed were defined as compliant. The pill count was recorded. The percentages of compliant patients and mean compliance (chi squared, Student's t) were analysed. 108 individuals, 41 men and 67 women, completed the trial. There was no difference between the two groups as to age, sex, evolution time, number of diseases and dosage of medicines consumed. 71.3% were compliant (CI, 62.8-79.8%), CG = 61.8% and IG 81.1% (p < 0.05). The mean percentage of compliance was 86.1 +/- 14.3 overall, with CG = 83.8 +/- 14 and IG 88.5 +/- 14 (p = NS). CONCLUSIONS: The HE intervention with a group session and postal back-up is an effective way of improving therapeutic compliance in cases of hypercholesterolaemia.