Key result
Reference center follow-up linked to a ~10% absolute improvement in BP control.
Why the study?
Hypertension has high prevalence, low control rates, and leads to cardiovascular complications, necessitating evaluation of blood pressure control and outcomes over time.
Does long-term follow-up at a specialized reference center improve blood pressure control and reduce cardiovascular outcomes in hypertensive patients?
Cohort (n=1,298)
No
Does long-term follow-up at a specialized reference center improve blood pressure control and reduce cardiovascular outcomes in hypertensive patients?
Absolute Event Rate: 39.6% vs 29.6%
p-value: p=0.001
Despite improved blood pressure control rates over 5 years at a specialized center, patients experienced worsening of other cardiovascular risk factors and increased incidence of cardiovascular events.
Multidisciplinary hypertension care achieved ~68% BP control; hypothesis-generating for diabetes-specific barriers in observational cohorts.
BACKGROUND: Hypertension is a public health problem, considering its high prevalence, low control rate and cardiovascular complications. OBJECTIVE: Evaluate the control of blood pressure (BP) and cardiovascular outcomes in patients enrolled at the Reference Center for Hypertension and Diabetes, located in a medium-sized city in the Midwest Region of Brazil. METHODS: Population-based study comparing patients enrolled in the service at the time of their admission and after an average follow-up of five years. Participants were aged ≥ 18 years and were regularly monitored at the Center up to 6 months before data collection. We assessed demographic variables, BP, body mass index, risk factors, and cardiovascular outcomes. RESULTS: We studied 1,298 individuals, predominantly women (60.9%), and with mean age of 56.7 ± 13.1 years. Over time, there was a significant increase in physical inactivity, alcohol consumption, diabetes, dyslipidemia, and excessive weight. As for cardiovascular outcomes, we observed an increase in stroke and myocardial revascularization, and a lower frequency of chronic renal failure. During follow-up, there was significant improvement in the rate of BP control (from 29.6% to 39.6%; p = 0.001) and 72 deaths, 91.7% of which were due to cardiovascular diseases. CONCLUSION: Despite considerable improvements in the rate of BP control during follow-up, risk factors worsened and cardiovascular outcomes increased.
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Filho et al. (2015) conducted a cohort in Hypertension (n=1,298). Follow-up at a Reference Center vs. Admission (baseline) was evaluated on rate of BP control (p=0.001). Follow-up at a reference center for an average of 5 years improved blood pressure control from 29.6% to 39.6% (p = 0.001), despite worsening of other risk factors.
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