High blood pressure is one of the major public health risk factors. So, have Pressure under control That is the key. For this, something obvious is needed: taking blood pressure or taking it for the patient when the doctor comes to the office. The incredible thing is that Many doctors do not comply With this primary procedure of clinical check-up.
A study conducted by the Argentine Society of Arterial Hypertension (SAHA) titled “Argentine Registry of Blood Pressure Measurement in Office” revealed that Only 14 percent of health professionals They take their patients’ blood pressure.
“In Argentina, as in many countries, it is unknown How often measurements are made and recording of blood pressure in patients who use the healthcare center. Our hypothesis is that there is Medical inertia Primarily in cardiovascular disease-related specialties, the first link in the diagnosis of high blood pressure produces deficits,” says the SAHA work.
9 institutions (2 public and 7 private) from 6 provinces of the country participated in the study: Buenos Aires, Córdoba, Mendoza, Salta, Santa Cruz and Santa Fe. In total, they were surveyed. 2,982 consultations were conducted during a day. Blood pressure was measured in 420 of 2,982 consultations, with no difference between men and women.
“That History of high blood pressure and cardiovascular diseases (CVD) were the variables most associated with blood pressure measurement and recording. The presence of cancer was associated with 50 percent less The possibility of measuring pressure,” the report suggests.
In conclusion, the researchers claim to have “confirmed the extreme hypothesis Low measurement prevalence and blood pressure registries in medical institutions in Argentina. They also assert that “there is bias when measuring pressure In favor of known hypertensives or tendency not to measure pressure in people with previous CVD and patients with a history of oncological disease.”
High blood pressure is the most prevalent risk factor and is estimated One in every 2 people In Argentina people over the age of 30 suffer from it. “Unfortunately, the level of knowledge and control of this disease continues deficit. This deficit is unacceptable if it is believed to be a disease A relatively easy diagnosis and management with current treatments,” he says.
Attributed to low rate of knowledge and control Multiple factorswhich include “patient-specific factors (non-adherence to medication, adverse effects of medication, lack of knowledge of risks), as well as treatment benefits, memory impairment, education and income level, medical enactment (consultation). Time, availability of approved blood pressure monitors.” and therapeutic inertia) and healthcare system (Access to counselling, facility to take blood pressure, health education).”
Regarding the low measurement of pressure in cancer patients, it is said that “it is possible that doctors leave it, which is related to the oncological disease. Short life span and is associated with cardiovascular risk of hypertension in the long term. However, many types of tumors have prolonged life expectancy and the prevalence of cardiovascular comorbidities, including hypertension, has increased and worsened depending on the oncological therapy used.
The research results are also lapidary to other medical specialties. “Strikingly, we observed the presence of diabetes Not associated with increased pressure intakeAnd consistent with this finding, patients attending diabetes counseling were one of the groups in which their blood pressure was measured and reported least frequently (3.6%).
What do you attribute this omission to? “Perhaps the perception of glycemic control (glucocentric) prevents the diabetologist or general clinician from approaching the patient. From Global Cardiovascular RiskWhere the value of pressure is much higher than glycemic control, especially in these patients where the prevalence of hypertension in all its forms (daytime, nocturnal and resistant) increases,” they conclude.
“Medical and Therapeutic Inertia”
Marcos Marin, a cardiologist who specializes in high blood pressure and former president of SAHA, says, “Although blood pressure should be measured in medical consultations, the bad news is that doctors do not measure blood pressure. It is very easy to diagnose. And most doctors don’t. We talk about medical and therapeutic inertia. It would be ideal for every doctor, in addition to a hanging stethoscope, to have Own blood pressure monitor, because the hospital isn’t going to give it to them and neither is the sanatorium. Every doctor should have an approved automatic blood pressure monitor. If not, another option for the family is to have a blood pressure monitor at home, which can be rotated among its members. It empowers the patient.
Only 14 percent of doctors took a patient’s blood pressure in the office.“Hypertension is a major risk factor for stroke. It is another risk factor for myocardial infarction. This is not seen in highly developed countries, because Hypertension is better treated. Better control of patients. The level of hypertension control in the United States or Germany is between 50 and 60 percent. We barely arrived 20 percent” adds Marin.
“In Argentina, out of every 100 hypertensive patients, 40 don’t even know it (access to the health system should be the most important factor there). Of the other 60 who know they have hypertension, More than half are not well controlled. Their blood pressure values did not reach the therapeutic objectives (14/9 in our country) and for those who have already had an event or have diabetes, that objective drops (13/8),” explains the expert.
Why after 60 years? It is more likely That people become hypertensive? “The pressure depends on the volume of blood pumped out by the heart and the peripheral resistance, that is, how the arteries are. And with age the arteries become more rigid, less flexible. This increase in stiffness causes an increase in resistance. Therefore, as age increases, the prevalence of high blood pressure increases. By the age of 60, 60 percent of people suffer from it. 70, 70 percent and so it goes up.
How much does it affect? Eat less sodium and exercise To fight hypertension? “Having good habits helps prevent hypertension. then appears. But there is no study that concludes that if you are physically active and eat less salt, you will never get high blood pressure. Yes, those are the two basic pillars for everyone and even more so for people with hypertension. Sodium consumption in Argentina 12 grams of salt per day. In the province of Buenos Aires, bakeries were required by law to make bread with less salt, and this dropped the average from 12 to 11. When what is recommended for the population should be 5 or 6 grams of salt per day. “We eat twice what is considered healthy.”
After all, the cardiologist recalls that “just as eating too much sodium is bad, it’s good to eat too much. Lots of potassium to resist. If you eat more potassium than salt, it will have a huge impact on your health. Potassium is found in tomatoes, kiwi and bananas. I tell my patients that sometimes you can afford to eat a crumb sandwich or a slice of pizza but then the potassium should be high.
