Alfonzo GJP, Castillo MI, Delgado-Orama FA, Alban P

Language: Spanish
References: 0
Page: 97-108
PDF size: 98.69 Kb.

ABSTRACT

Introduction: Isolated systolic arterial hypertension (SAH) is an important risk for health, as it is the expression of vascular remodeling final phase, due to its high frequency and associated morbidity and mortality, representing between 45% - 76% of uncontrolled hypertensive patients.
Objectives: Identify diagnostic and therapeutic criteria on isolated systolic arterial hypertension of professionals from different clinical specialties in Havana.
Methods: Three surveys were conducted in Havana by the same author in 2001- 2005, 2006-2010 and 2015-2016 to answer four basic questions: What was the criterion used for diagnosis? What were the sources of knowledge? What therapeutic measures did doctors use for their treatment? What were the goals of systolic blood pressure to achieve?
Results: The respondents who used the 4th korotkoff noise for diastolic blood pressure diagnosis ranged between 23.2% and 59.2%. Consensus guidelines were used between 42.2% and 8% and the Cuban guidelines were used between 40.2% and 79.2%, while clinical experience ranged between 78.8% and 98.9%.100% uses non-pharmacological treatment. In the pharmacological treatment, diuretics (70% - 85%) were the first option. Most of the doctors surveyed started pharmacological treatment with figures from systolic arterial hypertension of 140 mmHg. In some of the surveys, up to 40.7% do not consider it necessary to use antihypertensive drugs in people over 60 years of age. Those who started in patients under 60 years of age ranged between 36% and 69% with a target pressure of = 140 mmHg and between 23% and 74.4% in those over 60 using 140 mmHg as a treatment goal.
Conclusions: One third of physicians of clinical specialties use the 4th korotkoff noise as a technique to measure isolated systolic hypertension. Insufficient use of the guides, both national and foreign was observed. The non-pharmacological treatment was universally accepted. Diuretics are still the first pharmacological option treatment. There are specialists who are tolerant and do not treat systolic arterial hypertension adequately, especially in patients older than 60 years. The vast majority of the respondents used figures of equal to or less than 140 mmHg systolic blood pressure as the treatment goal. It is necessary to update concepts and criteria about systolic arterial hypertension.