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Uncontrolled hypertension in primary care
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