Avaliação do tratamento farmacológico para a hipertensão arterial em um serviço de referência

Abstract

Hypertension is a disease difficult to control, responsible for a lot of deaths worldwide and an important risk factor in the development of cardiovascular disease. It can be treated with lifestyle changes (no drug treatment) or with the use of one or more drugs (drug treatment). The objective of this study was to evaluate the pharmacological treatment of hypertension in patients with a reference health care and blood pressure control achieved. This was a retrospective study conducted at the Hypertension League of the Federal University of Goiás (HL-FUG). Medical records of 1,129 active register patients who were in regular antihypertensive drug therapy were evaluated. Were collected socioeconomic and clinical variables related to the first and last visit and the drugs used in the last query before the collection that have been identified according to the pharmacological class. Descriptive analysis was performed and used the Wilcoxon test to compare the means of the initial and final blood pressure, the comparison between the prevalence of controlled and uncontrolled pressure was established with the Chi-Square test and Pearson correlations between age and the monitoring time with the values of systolic and diastolic blood pressure were obtained using the test Spearman (p <0.05). Among the active patients HL-FUG, 96.8% were in drug treatment. The mean age was 62.7 ± 12.4 years, 854 (75.6%) were female and 890 (78.8%) with companion. Most patients 796 (70.5%) were overweight and when started the treatment at the HL-FUG, 932 (82.6%) used two or more drugs. Where as monotherapy patients, the pharmacologic class most prescribed was AT1 receptor blockers of Angiotensine II (RBA II): 61 (31.0%). The most common combination of two drugs was found RBA II with diuretic, 161 (35.9%), followed inhibitor of angiotensine-converting enzyme (ACE-I) with diuretic, 150 (33.5%). The initial systolic blood pressure (SBP) was 148mmHg (CI: 148.21-153.09) and final 135mmHg (CI: 135.99-138.40) (p <0.001). The initial diastolic (DBP) was 91mmHg (CI: 92,49-94,43), and the final was 82mmHg (CI: 81,79-83,27) (p <0.001). There was an increase in the number of patients with controlled pressure from 24.4% to 36.7%. In conclusion, most patients from HL-FUG was in pharmacological treatment with two drugs or more drugs. The AT1 receptor blockers of Angiotensine II is the pharmacological class most used as monotherapy and also associated with diuretic. There was a reduction on blood pressure as systolic as diastolic compared to the initial consultation and final consultation assessed. There was moderate correlation SBP with the age.