engleski

MANAGEMENT OF ARTERIAL HYPERTENSION IN PRIMARY CARE : IS IT ENOUGH TO TREAT THE PATIENT BASED ON CONVENTIONAL OFFICE BLOOD PRESSURE MEASUREMENTS OR DO WE NEED TO COLLECT DATA THROUGH ABPM OVER 24 HOURS?

Objectives: In this study the we tried to elaborate whether it is enough to treat the patient based on conventional office blood pressure measurement or if we need to collect data through ABPM over 24hrs for the decision making on the management of arterial hypertension in primary care. Subject and method: In this study 168 patients were included, they were treated in eight offices of specialists of family medicine in Spit, which are part of the Community health center Split, during the period of 1st September 2018 and 1st of April 2019. We compared office systolic BP with ABPM average systolic BP, office diastolic BP with ABPM average diastolic BP, office systolic BP with ABPM day-time systolic BP, office diastolic BP with ABPM day-time diastolic BP and compared these with the reference values from the European Guidelines. Results: The average value of the office BP was 138.93 mmHg (SD= 22.37) for the systolic and 82.14 mmHg (SD=13.07) for the diastolic BP. The average ABMP was 134.93 mmHg (SD= 13.35) for systolic and 76.92 mmHg (SD= 9.04) for the diastolic BP. The office BP measurements were normotensive but the ABPM revealed systolic values that are hypertensive in both average and daytime measurement with normotensive diastolic values. Conclusion: As a conclusion we can say that even though traditionally office BP measurement was recommended as the golden standard method for diagnosing HT, in reality in routine clinical practice it is relatively inaccurate and dependent on many internal and external influencing factors. Therefore the most recent guidelines recommend 24-h ABPM for diagnosing hypertension. Since as it did in our study, ABPM provides more accurate readings it also has stronger prognostic value and best predicts all-cause and cardiovascular mortality. The advantages of ABMP over office BP measurement support its use in routine clinical practice.

Hypertension ; PHC ; ABMP

nije evidentirano