Articole semnate de acelasi autor in Revista Practica Medicala:

Uncontrolled hypertension in primary care

Romanian Journal of Medical Practice | Vol. IX, No. 4 (37), 2014

ISSN 1842-8258 | e-ISSN 2069-6108
ISSN-L 1842-8258
DOI: 10.37897/RJMP

National Awards “Science and Research”

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Elena ARDELEANU, Daniel LIGHEZAN, Rodica LIGHEZAN, Alexandra DELEANU, Daniela GURGUS, Marinela POPOVICI, Raul SUCIU and Patricia NICOLA

ABSTRACT

Background. The aim of the study was to assess the prevalence of uncontrolled hypertension and its characteristics in comparison with controlled hypertension.

Material and method. 3,145 hypertensive patients from 19 family medicine practices of Timiş County were evaluated from 2010 to 2014 clinically and by laboratory.

Results. After 12 months of monitoring, 1008 patients (32.05%) had controlled hypertension and 2137 (67.95%) had offi ce BP ≥ 140/90 mmHg, being considered uncontrolled. ABPM was performed in 690 patients with uncontrolled hypertension and it allowed to diagnose a “white-coat” effect in 34.18% of them, as they had normal blood pressure values recorded with ABPM. Abnormal values were found in 520 (65.82%), of which 360 (69.23%) were uncontrolled by treatment, 85 (16.35%) were untreated, 42 (8.08%) had resistant hypertension and 33 (6.34%) secondary hypertension. The most common causes of uncontrolled hypertension were: poor adherence to treatment, inadequate doses and combinations, excessive salt consumption, obesity, metabolic syndrome, secondary and resistant hypertension. Compared with controlled hypertension, uncontrolled hypertensive patients were more often older, presented more severe and long hypertension evolution, organ damage and cardiovascular complications.

Keywords: uncontrolled hypertension, diagnosis, primary care

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Prevalence of microalbuminuria in hypertension monitored in primary care

Romanian Journal of Medical Practice | Vol. X, No. 1 (38), 2015

ISSN 1842-8258 | e-ISSN 2069-6108
ISSN-L 1842-8258
DOI: 10.37897/RJMP

National Awards “Science and Research”

NEW! RJMP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Elena ARDELEANU, Maria DOROBANTU, Roxana DARABONT, Daniel LIGHEZAN, Rodica LIGHEZAN, Dacian PURCARITA, Alexandra DELEANU, Daniela GURGUS, Patricia NICOLA and Shamsa BAAJ

ABSTRACT

The objectives of the study were to evaluate the prevalence of microalbuminuria (MAU) in patients with hypertension, monitored in primary care and to analyse the correlation between MAU, risk factors and associated parameters.

Material and methods. During 2010-2014 we evaluated a number of 910 patients from 19 family medicine offices of Timiş County. The general practitioners took a standardized history, performed a physical examination, measured height, weight, blood pressure, ABPM and heart rate, calculated body mass index and tested urine for MAU with Arkray test strips. The patients with hypertension and MAU were referred to diagnosis centres where they underwent echocardiography.

Results. After exclusion of patients with a history of renal disease and diabetes, MAU was present in 61 cases, 7.1%. The mean age of the MAU positive patients was 56±13.1 years, ranging from 29 to 79. The duration of hypertension was under 5 years in 4 (2.44%) patients, between 5-10 years in 35 (57.3%) and over 10 years in 22 (36%) Six patients with MAU (9.83%) had mild hypertension, 25 (40.9%) moderate and 30 (49.1%) severe hypertension. LVMI was 125 ± 28 g/m2 in the MAU absent group and 157 ± 56 g/ m2 in the MAU present group (<0.04). A stepwise logistic regression analysis showed significant positive effects of 24 h systolic blood pressure, weight and LVH (p<0.001 for all comparisons) on MAU. No other variable had a significant predictive effect on the presence or absence of MAU.

Conclusions. In patients with essential hypertension MAU was present in 7.1%, with a higher prevalence in uncontrolled than in controlled hypertension. MAU was associated with high blood pressure levels, obesity and LVH.

Keywords: hypertension, microalbuminuria, primary care

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