Análisis de la variabilidad de la presión arterial mediante la automedida de la presión arterial en Navarra / Analysis of the variability of blood pressure by self-measurement of blood pressure in Navarra

Objetivos. Dada la gran utilización del método diagnóstico que es la automedida de presión arterial (AMPA) y existiendo escasa clarificación sobre la variabilidad diurna y sobre el número de determinaciones de PA a realizar mediante AMPA se realizó este estudio. Método. Se seleccionó una muestra de 1.136 personas (población total, 2.084), aleatoria y estratificada por edad y sexo, de 25 a 64 años. Se excluyeron a los diagnosticados de hipertensión arterial (HTA). En la recogida de datos en consulta (C) se determinó la PA tres veces mediante el esfigmomanómetro de mercurio (Hg) en las dos primeras y mediante el aparato automático Omron 705 CP (ap autom) en la tercera. Se registró la frecuencia cardíaca (FC), la talla y el peso. Para la recogida de datos en el domicilio (D) se les instruyó en el manejo del ap autom y se les pidió que obtuviesen 9 mediciones de PA, tres por la mañana (M), tres por la tarde (T) y tres por la noche (N) durante tres días laborables (L) y uno festivo (F). Se aplicó la "t" de Student de medias pareadas y ANOVA monofactorial. Resultados. Las mediciones de PA (mmHg) en C y D se obtuvieron en 734 participantes. De ellos, 185 con una PA en C >= 140/90. Las medias de presión sistólica/presión diastólica (PS/PD) en C con el Hg fueron: 123,5 ± 15,1/76,4 ± 10,3 y 122,4 ± 14,4/75,5 ± 10 y con el ap autom de 123 ± 16,1/73,7 ± 10,3. La media de PS/PD en el D de toda la muestra fue: 115 ± 14,3/69,2 ± 9 y en el grupo con PA en C < 140/90, la media de PS fue 111 ± 12,2 y de PD 66,8 ± 7,6. La media de FC en la C fue de 70,3 ± 10,4 (pulsaciones/minuto). La media de FC en el D de toda la muestra fue 67,9 ± 9,7 y en el grupo con PA < 140/90 en C fue de 67 ± 9,6. Al comparar la PA de la C y del D existieron diferencias significativas entre las determinaciones en C en relación con las del D (M, T o N) en los días L y F (p < 0,05); siendo superior la PA en C. La FC fue también diferente en la C y en el D, siendo superior en C que en el D. Al analizar las tres tomas de la M de cada día se observó que existía una diferencia significativa de la PA tanto en la primera toma que se realizaba por la M, por la T y por la N del primer día en relación con la segunda y la tercera tomas del mismo día (p < 0,05). Respecto a la FC se observaron diferencias significativas entre la primera toma de la M en comparación con la segunda y la tercera tomas de la M del primer día (p < 0,05). Al comparar la PA de la M, la T y la N de los días L se observó que existían diferencias significativas entre las tomas de la M y la N (p < 0,05). Al comparar el día L y el F no existieron diferencias significativas de PS entre las M (p = 0,998) y las T (p = 0,934) del día L y F, pero sí existieron diferencias entre PS de las N (p < 0,05). La PD no presentó diferencias significativas por las T (p = 0,268), pero sí entre las M y las N (p < 0,05). Conclusiones. 1) Se demuestra una gran variabilidad entre las diferentes tomas de PA y se mantiene el ritmo circadiano, y 2) se recomienda realizar tres determinaciones por la M, tres por la T y tres por la N durante tres días, debiendo eliminar sólo la primera determinación del primer día

Objectives. This study was conducted given the great use of the diagnostic method that is the self-measurements of blood pressure (SMBP) and there being scarce clarification on the daytime variability and the number of BP determinations to be conducted by SMBP. Method. A sample of 1,136 persons (total population, 2,084) was chosen. It was randomized and stratified by age and gender, from 25 to 64 years. Those diagnosed of HBP were excluded. PB was determined three times in the consultation (C) data collection. This was done by mercury sphygmomanometer (Hg) in the first two and by automatic Omron 705 CP apparatus (ap autom) in the third. Heart rate (HR), height and weight were recorded. For home (H) data collection, they were instructed in the management of the ap autom and were asked to obtain 9 BP measurements, three in the morning (M), three in the afternoon (A) and three at night (NO) for three work (W) days and one holiday (H). The Student's "t" test of paired means and monofactorial ANOVA were administered. Results. The blood pressure measurements (mmHg) in C and H were obtained in 734 participants. Of them, 185 had a BP C >= 140/90. SP/DP means in the C with the Hg were 123.5 ± 15.1/76.4 ± 10.3 and 122.4 ± 14.4/75.5 ± 10 and with the ap autom, 123 ± 16.1/73.7 ± 10.3. The mean SP /DP at H of all the sample was 115 ± 14.3/69.2 ± 9 and in the group with BP at C < 140/90, the mean SP was 111 ± 12.2 and DP, 66.8 ± 7.6. Mean HR in the C was 70.3 ± 10.4 (beats/minute). Mean HR at H of all the sample was 67.9 ± 9.7 and in the group with BP < 140/90 in C it was 67 ± 9.6. When the BP of the C was compared with that of the H, there were significant differences between the measurements in C in relationship with those in H (M, A or N) on the days of W and H (p < 0.05); the BP being greater in C. The HR was also different in the C and H, it being greater in the C than in the H. When the three measurements of the M of each day were analyzed, it was observed that there was a significant different of BP both in the first done in the M, the A and N of the first day in relationship with the 2nd and 3rd measurements of the same day (p < 0.05). Regarding the HR, significant differences were observed between the 1st measurement of the M in comparison with the 2nd and 3rd measurements of the M of the first day (p < 0.05). When the BP of the M, A and N of the W days were compared, it was observed that there were significant differences between the measurements of the M and N (p < 0.05). When the W and H day were compared, there were no significant differences of SP between M (p = 0.998) and A (p = 0.934) of the W and H day. However, there were differences between SP of the N (p < 0.05). The DP did not have significant differences in the A (p = 0.268), but did between the M and N (p < 0.05). Conclusions. 1) A large variability is shown between the different BP measurements and the circadian rhythm is maintained, and 2) it is recommended to make three measurements in the M, three in the A and three at N for three days, and only the 1st measurement of the first day should be eliminated

[Hepatitis A seroprevalence in Navarra]. / Seroprevalencia de hepatitis A en Navarra.

BACKGROUND: Determine the hepatitis A seroprevalence in Navarra. Because of the improvement in the hygienic-sanitary conditions, we hope to find a decline of the total prevalence. METHODS: Population and random sample of Navarra, obtained by stratified sampling with proportional allocation of sex, age, and area of health care: 1,440 individuals over 15 years of age. Detection of total antibodies by enzyme immunoassay of microparticles. RESULTS: Global seroprevalence: 79.24%. By age: 9.09% (16-19 years), 35.32% (20-29 years), 77.78% (30-39 years), 97.31% (40-49 years), 98.58% (50-59 years), 97.51% (60-69 years), 99.33% (70-79 years) and 100% (>79 years). By gender: 78.76% in men and 79.7% in women. Rural area 82.04% and urban area 75.77%. Areas of health care: Tafalla, 89.06%; Estella, 87.91%; Tudela, 82.88%; northern, 77.22%; Pamplona, 75.05%, and eastern, 70.97%. CONCLUSIONS: The global prevalence is 79.24% and increasing progressively with the age. Greater seroprevalence in rural areas and in people in contact with livestock. Characteristics of the persons with seroprevalence for HAV in Navarra: inhabitant of the average area, of rural area, with average age and in contact with livestock.