Aplicabilidade do uso rotineiro da automedida da pressão arterial para o controle das cifras tensionais e para a adesão ao tratamento do paciente hipertenso.
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2011-06-13
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Universidade Federal de Goiás
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The casual measurement of blood pressure (BP) is subjected to a great variability, it is interesting to seek new methods that can either contribute to adhesion to hypertension treatment or overcome the limitation of this variability. It was evaluated if the insertion of self measured blood pressure (SMBP) in the routine of treatment of hypertensive patients favors the improvement in adhesion, on BP control and metabolic profile in patients accompanied at the Arterial Hypertension League. The study included 57 patients, 38 in Study Group (SG) and 19 in Control Group (CG), followed by 12 months. They were assessed at randomization (V1), the sixth months (V2) and twelfth months (V3). Comparing the averages of the BP by casual measurements and by Ambulatory Blood Pressure Measurement (ABPM), laboratory tests and the
answers to the questionnaire about the lifestyle.It was used the instruments: OMRON HEM 714 for SMBP, OMRON 705 CP to casual measurement and Monitor SPACELABS 9002 to the ABPM. The average age was 62.05 ± 10.78 years and 55.42 ± 11.87 in the SG and CG (p = 0.03) respectively. The values of Systolic Blood Pressure (SBP) by casual measurements in the SG and CG were 140.01± 16.73 mmHg and 141.79± 23.21 mmHg in V1 (p = 0.72), 135.49± 12.73 mmHg and 145.69± 19.31 mmHg in V2 (p = 0.02) and 131.64± 19.28 mmHg and 134.88± 23.21 mmHg in V3 (p = 0.59). For Diastolic Blood Pressure x viii (DBP) the values were 84,13±10,71mmHg and 86,29±10,35mmHg in V1 (p=0,47), 81,69±10,88mmHg and 89,61±11,58mmHg in V2 (p=0,02),
80,31±11,83mmHg and 86±13,38mmHg in V3 (p=0,12).The SG patients showed adhesion to non-pharmacological treatment similar to the CG, but they had better adhesion to medicine treatment and used fewer antihypertensive drugs. There was no difference between groups in the comparison of renal
function and metabolic profile (glucose, cholesterol and creatinine). To compare and correlate the levels of BP obtained by SMBP with casual measurement and ABPM were evaluated 32 hypertensive patients who performed the three methods of BP measurement within a smaller range 30 days. The average values of SBP and DBP for SMBP were 134±15.71 mmHg and 79.32±12.38 mmHg. In the casual measurement averages of SBP and DBP were respectively 140.84±16.15mmHg and 85±9.68mmHg. The average values of ABPM during
daytime were 130.47±13.26mmHg and 79.84±9.82 mmHg for SBP and DBP. In the comparative analyze SMBP showed values similar to those of ABPM (p = 0.06 for SBP and p = 0.72 for DBP) and different to casual measurement (p =
0.03 for SBP and p = 0.00 for DBP). It is concluded that the SMBP is able to improve the adhesion to medicine treatment and the control of BP evaluated by the casual measurement in the first six months of the following, and present comparison and correlation with the ABPM better than casual measurement do. It represents, therefore, an alternative to monitoring the blood pressure of hypertensive person.
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SOUZA, Weimar Kunz Sebba Barroso de. Applicability of the routine use of pressure automedida
pressure to control their blood pressure and the
adherence to treatment of hypertensive patients.. 2011. 114 f. Tese (Doutorado em Ciencias da Saude) - Universidade Federal de Goiás, Goiânia, 2011.