The use of a telematic connection for the follow-up of hypertensive patients improves the cardiovascular prognosis.
J Hypertens
; 23(7): 1417-23, 2005 Jul.
Article
em En
| MEDLINE
| ID: mdl-15942466
ABSTRACT
BACKGROUND:
Inadequate blood pressure (BP) control could be due to incorrect management of hypertensives caused by the lack of interaction between general practitioners (GP) and hypertension specialists.OBJECTIVES:
To test the effectiveness on BP and total cardiovascular risk (TCVR) control of an internet-based digital network connecting specialists and GPs.METHODS:
We created a network among the Hypertension Clinic, Federico II University (Naples, Italy), 23 hospital-based hypertension clinics and 60 GPs from the area (CampaniaSalute Network, CS). Randomized GPs enrolled in CS could update online records of patients (n = 1979). As a control, we included 2045 patients referred to the specialist clinics by GPs from outside the network. All patients completed a 2-year follow-up.RESULTS:
CS provided a larger reduction in BP [systolic/diastolic BP (SBP/DBP) 7.3 +/- 0.4/5.4 +/- 0.3 versus 4.1 +/- 0.4/3.1 +/- 0.26 mmHg, CS versus control; P < 0.001 for both] and percentage of patients with BP < 140/90 mmHg (CS versus control baseline, 33 versus 34%, NS; end of follow-up, 51 versus 47%, chi = 13.371; P < 0.001). A European Society of Hypertension-European Society of Cardiology (ESH/ESC) TCVR score was calculated [from 1 (average) to 5 (very high TCVR)]. The CS group showed a reduction in the mean TCVR score (CS from 3.5 +/- 0.02 to 3.2 +/- 0, P < 0.01, ANOVA; control group 3.5 +/- 0.03 to 3.4 +/- 0.03, NS) and, accordingly, fatal and non-fatal major cardiovascular events (MACE) were less frequent (2.9 versus 4.3%; chi = 5.047, P < 0.02). CS predicts fewer MACE in multiple binary regression analysis (beta-7.27, P < 0.008) reducing the risk for MACE compared to control [odds ratio (OR) 0.838; 95% confidence interval (CI) 0.73-0.96].CONCLUSION:
Our results support the idea that telemedicine can achieve better control of BP and TCVR.
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Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
/
Telemedicina
/
Hipertensão
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2005
Tipo de documento:
Article