Characteristics of patients with hypertension and metabolic syndrome attended by different specialists
Por:
de la Sierra, A, Alegria, E, Martinez-Castelao, A, Morillas, C and Gonzalez-Segura, D
Publicada:
25 feb 2012
Ahead of Print:
20 abr 2011
Categoría:
Medicine (miscellaneous)
Resumen:
Background and objetive: A large number of patients with cardiovascular risk exhibit metabolic syndrome and are attended by several specialists. There is no information about possible differences in the clinical characteristics and management of these patients by these specialists. The aim of the present study was to evaluate possible differences in clinical features, blood pressure control, therapeutic effort, and therapeutic inertia among medical specialities attending hypertensive patients with metabolic syndrome (MS).
Patients and methods: Cross-sectional study carried out in 17 autonomous communities in Spain, in hypertensive patients with MS consecutively recruited in ambulatory units from departments of cardiology, internal medicine, endocrinology and nephrology. Demographic and clinical data, as well as blood pressure control were assessed. Therapeutic effort was defined as the proportion of patients using 3 or more antihypertensive drugs. Therapeutic inertia was defined as the proportion of patients without any change in antihypertensive treatment despite a lack of blood pressure control (values >= 140 and/or 90 mmHg).
Results: 2,453 patients (40% women) with a mean age of 64 (11) years were included in the study. We observed some differences in the specific MS components among specialities. Atherogenic dyslipidemia, defined as elevated triglycerides (97%) and/or HDL-cholesterol (61%) was more common in patients attended by cardiologists. Blood pressure control was better achieved by nephrologists (16-33%, depending on the criteria used), and it was accompanied by a greater therapeutical effort (59%). Therapeutical inertia in relation to antihypertensive treatment was more common among endocrinologists (56%).
Conclusions: Hypertensive patients with MS attended by different specialists have similar clinical features, although some differences are present, especially driven by more frequent lipid alterations among those attending cardiology departments. Nephrologists make a greater therapeutic effort and achieve a better blood pressure control. On the contrary, therapeutical inertia is higher among endocrinologists. (C) 2010 Elsevier Espana, S.L. All rights reserved.
Filiaciones:
Servicio de Medicina Interna, Hospital Universitario Mutua Terrassa, Terrassa, Barcelona, España.
Servicio de Cardiología, Clínica Universitaria de Navarra, Pamplona, Navarra, España
Servicio de Nefrología, Hospital Universitario Bellvitge, L’Hospitalet de Llobregat, Barcelona, España
Servicio de Endocrinología. Hospital Universitario Dr. Peset, Valencia, España
Departamento Médico, Almirall S.A., Barcelona, España
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