Efeito de uma intervenção combinada para otimização do controle da pressão arterial em pacientes com hipertensão pseudorresistente

Abstract

The resistant hypertension is the failure to control the blood pressure of a patient despite the concomitant use of three or more antihypertensive drugs, with different mechanisms of action in optimal doses, including a diuretic. Hypertension pseudo-resistente is defined as failure to control blood pressure caused by an inappropriate antihypertensive pharmacotherapy, nonadherence to anti-hypertensive drugs, inadequate blood pressure measurements or white-coat effect. The aim of this study is to measure the effect of an informational and behavioral intervention to optimize blood pressure control in patients with hypertension pseudoresistente. one randomized controlled trial in five basic health units in the city of Maceió, with follow-up three months was conducted. The patients were divided as follows: two groups, intervention and control. Belonging to the intervention group underwent the test protocol as the group of patients classified as control group received usual care unit. Totaling 180 participants including allocated into two groups: the intervention group with 140 participants and the control group with 40 participants, where the intervention group was divided in group 1, which used up to two antihypertensive (90 participants), group 2 that used more than two antihypertensive (50 participants). There was no refusal to participants nor exclusion of these after the start of the study. Regarding the blood pressure of patients had a reduction in blood pressure in groups of 4 to 7 mmHg in systolic pressure. Diastolic pressure mean pressure was lower in the intervention groups, and this lower in group 1 where the number of antihypertensive in use was also lower. The application protocol did not significantly alter the systolic pressure, this can be attributed to the presence of patients with true resistant pressure undiagnosed between the sample investigated patients. However, there was a reduction in the values of diastolic blood pressure in both intervention groups. A later study considering the informational and behavioral intervention as a secondary outcome should be conducted to investigate the change in diastolic pressure.