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[Hypertensive patients with poor blood pressure control in clinic. Study using ambulatory blood pressure monitoring].

OBJECTIVE
To describe the characteristics of hypertensive patients with poor clinical control of their blood pressure (BP > 140/90 mmHg), by examining the level of control indicated by out-patient monitoring of BP (OMBP).


DESIGN
An observational study with diagnostic intervention.


SETTING
Urban health centre.


PATIENTS
Hypertensive patients > 15 years old, with poor control of their BP and on the lists of 11 family doctor practices.


INTERVENTIONS
Hypertensive patients with their BP > 140/90 mmHg, measured in base conditions with a mercury Sphygmomanometer, were studied through a 24-hour OMBP (SpaceLabs 90202-90207). Good pressure using OMBP was defined as: BP mean in the monitoring period < 140/90 mmHg.


RESULTS
The study included 247 hypertensive patients (53.8% women, age 53); 39.3% treated with drugs. Patients with BP appearing well-controlled through OMBP (51%) were mainly women, with less damage to target organs, less evolution, less variability and less day and night pressure loads, when compared with the hypertensive patients with BP showing poor control in OMBP. No significant differences were detected between the two groups for the consumption of medicine.


CONCLUSIONS
In our survey half the hypertensive patients who recorded high BP in the clinic showed their pressure well-controlled when using OMBP. A more conservative therapeutic approach is suggested for these cases.