[Evaluation and control of hypertensive diabetics seen in Primary Care centres in Spain. BRAND II study]. / Evaluación y control de los hipertensos diabéticos atendidos en centros de Atención Primaria de España. Estudio BRAND II.

OBJECTIVE: We aimed to verify the level of blood pressure and glucose control and treatment in hypertensive diabetics seen in Primary Care Centres in Spain. DESIGN: Descriptive study conducted on hypertensive diabetic patients who attended primary care centres for any reason. LOCATION: Primary Care centres throughout Spain. PARTICIPANTS: The study included 6,777 patients. MEASUREMENTS: Blood pressure, weight, height, waist circumference, blood analysis and treatment were recorded RESULTS: The mean age of the sample was 64.40 (11.50) years. Mean blood glucose was 141.8 (39) mg/dl, glycosylated haemoglobin was ≤7% in 45.9% of the sample, and blood pressure was under control (BP≤130/80 mmHg) in 9.8% of the patients studied. LDL Cholesterol was ≤100mg/dl in 25.3% of the sample. The drugs most used to control diabetes were; sulphonylureas 2259 patients (33.3%) and biguanides 3768 patients (55.6%). A total of 556 patients were on treatment with insulin, which represented 8.2% of the population studied. The drugs most used for hypertension were; diuretics in 3395 patients (50.1%) and angiotensin-converting enzyme inhibitors in 4053 patients (59.8%). CONCLUSIONS: A large proportion of hypertensive diabetics are insufficiently controlled.

[Prevalence of chronic kidney disease in hypertensive aged women treated in primary care. MERICAP Study]. / Prevalencia de enfermedad renal crónica en mujeres hipertensas de edad avanzada atendidas en atención primaria. Estudio MERICAP.

BACKGROUND AND OBJECTIVES: Information about the prevalence of chronic kidney disease (CKD) in the population treated in primary care is scarce. The aim of this study was to assess the prevalence of CKD in Spanish hypertensive women aged 64 years or older, and to determine possible associated factors. PATIENTS AND METHOD: Cross-sectional study including women with a diagnosis of hypertension selected by consecutive sampling in primary care. CKD was diagnosed when glomerular filtration rate was<60 ml/min/1.73 m(2) (MDRD). We assessed sociodemographic and clinical data, cardiovascular risk factors, and the presence of cardiovascular disease. RESULTS: The sample included 3782 women with a mean age of 73.6 ± 6.1 years. CKD (glomerular filtration rate<60 ml/min/1.73 m(2) was present in 53.4% (95% CI: 51.8-55.0). Masked CKD (serum creatinine<1.2mg/dl) was present in 25.7% (95% CI: 26.3-29.1). The prevalence increased with age (51% in those younger than 75 and 60.7% in women older than 84 (P<.001). With respect to those with normal renal function, hypertensive women having CKD were older, showed higher values of blood pressure, and had more frequently dyslipidemia, elevated plasma glucose, target organ damage and cardiovascular disease (P<.001). In a multivariate analysis, CKD was associated with coronary heart disease (OR: 1.9), hyperglycemia (OR: 1.6), hypertriglyceridemia (OR: 1.5), and elevated diastolic blood pressure (OR: 1.4). CONCLUSIONS: More than half of hypertensive women aged 64 years have CKD and of these about half have normal creatinine values.