Factores asociados a descontrol hipertensivo en pacientes que acuden a consulta en primer nivel de atención

Abstract

Introduction: In Mexico, 40% of patients attended at first level of care with hypertension present optimal figures, there are management guidelines for hypertension in which guidelines are provided for the control of the various factors that may be involved in inadequate control. Objective: To determine factors associated with Uncontrolled Hypertension in patients attending a first level of care. Material and Methods: After authorization from the local health research and ethics committee, an observational, cross-sectional, descriptive study was conducted at HGZ/MF Nº12, in a single evaluation of the objective of interest, during November 2022 to May 2023, we documented data on patients who came for consultation and reported control and uncontrolled figures. We sought to identify factors associated with hypertensive dyscontrol. We analyzed the data in SPSS v.26 in a descriptive and inferential analysis. A value of p=0.05 was considered significant. REGISTRY: R-2022-1603-010. Results: We included 148 hypertensive patients between 18 and 80 years of age, 54.7% female and 45.3% male. 14.2% were normal weight, 33.8% were overweight and 51.4% were obese. 23.6% smoked. 46.6% were compliant with antihypertensive treatment and 53.4% were non-compliant. 50.7% of the patients were uncontrolled. Male sex OR:2.180(95%CI 1.126-4.219, p=0.022), obesity OR:3.2(95%CI 1.639-6.289, p=0.001), smoking OR:5.6 (95%CI 2.264- 13.938, p=0.0002) and nonadherence to treatment OR:18.7, 95%CI 8.157-42.885, p=0.0001) were associated with hypertensive non-adherence. Conclusions: Factors associated with hypertensive dyscontrol were male sex, obesity, smoking and therapeutic non-adherence.

Introducción: En México el 40% de los pacientes atendidos en primer nivel de atención con hipertensión arterial presenta cifras óptimas, existen guías de manejo para la HTA en las cuales se proporcionan las pautas para el control de los diversos factores que pueden intervenir en el control inadecuado. Objetivo: Determinar factores asociados a descontrol hipertensivo en pacientes que acuden a consulta en un primer nivel de atención. Material y Métodos: Previa autorización del comité local de ética e investigación en salud se realizó un estudio observacional, transversal y descriptivo en el HGZ/MF Nº12, en una sola evaluación del objetivo de interés, durante noviembre 2022 a mayo de 2023 documentamos datos de pacientes que acudieron a consulta que reportaron cifras de control y descontrol. Buscamos identificar los factores asociados al descontrol hipertensivo. Analizamos los datos en SPSS v.26 en un análisis descriptivo e inferencial. Un valor de p<0.05 se consideró significativo. REGISTRO: R–2022–1603–010 Resultados: Se incluyeron 148 pacientes hipertensos entre 18 y 80 años, 54.7% femeninos y 45.3% masculinos. 14.2% tenían normopeso, 33.8% sobrepeso y 51.4% obesidad. El 23.6% fumaban. El 46.6% eran cumplidores con el tratamiento antihipertensivo y 53.4% no cumplidores. 50.7% de los pacientes se encontraban descontrolados. Se asociaron a descontrol hipertensivo el sexo masculino OR:2.180(IC95% 1.126-4.219, p=0.022), la obesidad OR: 3.2(IC95% 1.639-6.289, p=0.001), el tabaquismo OR:5.6 (IC95% 2.264- 13.938, p=0.0002) y la no adherencia terapéutica OR:18.7, IC95% 8.157-42.885, p<0.0001). Conclusiones: Los factores asociados a descontrol hipertensivo fueron el sexo masculino, obesidad, tabaquismo y la no adherencia terapéutica.