Relationship between renal function and heart failure in hypertensive patients.

The HICAP (Hypertension and Heart Failure in Primary Care) study is a cross-sectional, multicentre, epidemiological study conduced in primary care centres in Spain. The results indicate that among hypertensive patients without heart failure (HF), diagnosed renal dysfunction is associated with the risk for developing HF and that the renal function evaluation using the Modification of Diet in Renal Disease Study Group formula could be useful to detect hypertensive patients at high risk of developing HF.

[Clinical characteristics and management of hypertense patients diagnosed of heart failure in primary health care in Spain. HICAP Study]. / Características clínicas y manejo de pacientes hipertensos con diagnóstico de insuficiencia cardíaca en Atención Primaria en España. Estudio HICAP.

OBJECTIVE: To know the proportion of hypertensive patients with heart failure and its treatment in Primary Health Care. METHODS: Observational, multicenter study conducted in Primary Health Care. The sample selection technique was a non-probabilistic selection of consecutive cases. Hypertensive patients with blood test and electrocardiogram performed in the last 6 months were included in this study. RESULTS: A total of 1288 physicians who included 6719 patients participated in the study. Only 6375 were considered valid. The proportion of patients diagnosed of heart failure was 18.9%. In 39% of the cases, the diagnosis was made in Primary Health Care and 57.5% of the patients had undergone an electrocardiography. A total of 76.7% of the patients were functional class I-II and 36.1% had systolic dysfunction. Follow-up was performed in 33.6% of cases only in Primary Health Care. Seventy-seven percent of the patients were not treated with beta blockers and 11% did not take renin-angiotensin system blocker drugs. CONCLUSION. The proportion of hypertensive patients diagnosed of heart failure is high but their diagnostic management and therapy does not seem to be appropriate.

[Prevalence and risk of developing heart failure in hypertensive patients managed in Spanish primary care centres. HICAP study]. / Prevalencia y riesgo de desarrollar insuficiencia cardíaca en los hipertensos españoles atendidos en Atención Primaria. Estudio HICAP.

OBJECTIVE: The objective was to establish the proportion of hypertensive patients diagnosed with heart failure (HF) and at high risk of developing it in Primary Care (PC) centres in Spain. METHODS: Observational, multicentre study. Each investigator included data from 5 consecutive hypertensive patients. A routine laboratory test and a electrocardiogram performed in the previous 6 months had to be available for each patient. RESULTS: Data from 6,375 patients were suitable for the study objectives. The proportion of patients diagnosed with HF was 18.9% (95% confidence interval: 17.97-19.90%), and increased with age. Among the patients not previously diagnosed with HF, 59.1% (95%CI: 57.7-60.5%) had a high risk of developing it. Blood pressure and other cardiovascular risk factors control in high risk patients was insufficient. CONCLUSION: The proportion of hypertensive patients diagnosed with HF and at high risk for developing it is high in PC. Blood pressure and other cardiovascular risk factors control should be improved to avoid the development of HF among high risk patients.

Características clínicas y manejo de pacientes hipertensos con diagnóstico de insuficiencia cardíaca en Atención Primaria en España. Estudio HICAP / Clinical characteristics and management of hypertense patients diagnosed of heart failure in primary health care in Spain. HICAP Study

Objetivos. Conocer la proporción de pacientes hipertensos con insuficiencia cardíaca y su manejo en Atención Primaria. Métodos. Estudio observacional, multicéntrico, realizado en Atención Primaria. La técnica de selección de la muestra fue no probabilística de selección de casos consecutivos, se incluyeron pacientes hipertensos con analítica y electrocardiograma realizados en los últimos 6 meses. Resultados. Participaron 1.288 médicos que incluyeron 6.719 pacientes, se consideraron válidos 6.375. La proporción de pacientes con diagnóstico de insuficiencia cardíaca fue del 18,9%. En un 36,9% de los casos el diagnóstico lo hizo Atención Primaria y a un 57,5% de los pacientes se les había hecho un ecocardiograma. Un 76,7% de los pacientes eran de clase funcional I-II y un 36,1% tenía disfunción sistólica. En un 33,6% de los casos el seguimiento lo hacía solo Atención Primaria. Un 77% de los pacientes no estaba tratado con bloqueadores beta y un 11% no tomaba fármacos bloqueadores del sistema renina-angiotensina. Conclusiones. La proporción de pacientes hipertensos con diagnóstico de insuficiencia cardíaca es elevada, pero su manejo diagnóstico y terapéutico no parece adecuado (AU)

Objective. To know the proportion of hypertensive patients with heart failure and its treatment in Primary Health Care. Methods. Observational, multicenter study conducted in Primary Health Care. The sample selection technique was a non-probabilistic selection of consecutive cases. Hypertensive patients with blood test and electrocardiogram performed in the last 6 months were included in this study. Results. A total of 1288 physicians who included 6719 patients participated in the study. Only 6375 were considered valid. The proportion of patients diagnosed of heart failure was 18.9%. In 39% of the cases, the diagnosis was made in Primary Health Care and 57.5% of the patients had undergone an electrocardiography. A total of 76.7% of the patients were functional class I-II and 36.1% had systolic dysfunction. Follow-up was performed in 33.6% of cases only in Primary Health Care. Seventy-seven percent of the patients were not treated with beta blockers and 11% did not take renin-angiotensin system blocker drugs. Conclusion. The proportion of hypertensive patients diagnosed of heart failure is high but their diagnostic management and therapy does not seem to be appropriate (AU)

Prevalencia y riesgo de desarrollar insuficiencia cardíaca en los hipertensos españoles atendidos en Atención Primaria. Estudio HICAP / Prevalence and risk of developing heart failure in hypertensive patients managed in Spanish primary care centres. HICAP study

Objetivos. Conocer la proporción de pacientes coninsuficiencia cardíaca (IC) y con alto riesgo dedesarrollarla entre los hipertensos atendidos en lasconsultas de Atención Primaria (AP) en España.Métodos. Estudio transversal y multicéntrico en elque cada investigador incluyó datos de 5hipertensos consecutivos que acudieron a suconsulta y que contaban con una analítica y unelectrocardiograma realizados en los últimos 6meses.Resultados. Se recogieron datos válidos de 6.375hipertensos. La proporción de pacientes condiagnóstico de IC fue de 18,9% (intervalo deconfianza al 95% [IC95%]: 17,97-19,90) yaumentaba progresivamente con la edad. De lospacientes que no habían sido previamentediagnosticados de IC, el 59,1% (IC95%: 57,7-60,5)presentaba un alto riesgo de desarrollar IC. Elcontrol de la presión arterial y otros factores deriesgo cardiovascular en estos pacientes «conalto riesgo» era insuficiente.Conclusión. Los datos indican que la proporción dehipertensos diagnosticados de IC y con altoriesgo de desarrollar la enfermedad es alta en AP.Se debería mejorar el control de la presión arterial yotros factores de riesgo para intentar evitar eldesarrollo de la IC en los hipertensos con altoriesgo

Objective. The objective was to establish theproportion of hypertensive patients diagnosed withheart failure (HF) and at high risk of developing it inPrimary Care (PC) centres in Spain.Methods. Observational, multicentre study. Eachinvestigator included data from 5 consecutivehypertensive patients. A routine laboratory test anda electrocardiogram performed in the previous 6months had to be available for each patient.Results. Data from 6,375 patients were suitable forthe study objectives. The proportion of patientsdiagnosed with HF was 18.9% (95% confidenceinterval: 17.97-19.90%), and increased with age.Among the patients not previously diagnosed withHF, 59.1% (95%CI: 57.7-60.5%) had a high risk ofdeveloping it. Blood pressure and othercardiovascular risk factors control in high riskpatients was insufficient.Conclusion. The proportion of hypertensivepatients diagnosed with HF and at high risk fordeveloping it is high in PC. Blood pressure andother cardiovascular risk factors control should beimproved to avoid the development of HF amonghigh risk patients