Reunión de consenso: Estrategias para un control eficaz de la hipertensión arterial en España Barcelona, España, 14 y 15 de octubre de 2005

Abstract

The goal of antihypertensive treatment is to reduce cardiovascular morbidity and mortality associated with high blood pressure. Various international organizations, including the Joint National Committee, the European Society of Hypertension and the WHO, have established precise treatment goals. These goals take into account the presentation of the disease or the presence of comorbidities, such as diabetes or target-organ damage, including renal failure or left ventricular hypertrophy. Despite these precise guidelines, however, high blood pressure control in different countries is far from reaching the desired treatment goals.

In Spain, controlled hypertension is classified as blood pressure persistently lower than 140/90 mmHg. Control rates range from 13%, reported in initial studies, to 39% in the more recent Controlpres 2003 and PRESCAP studies. Considering that 44.5% of Spaniards are aware of their hypertension and that 71.9% of these people are receiving some type of antihypertensive treatment, the absolute value for blood pressure control for in Spain for both known and unknown hypertension is around 16%.

The contents of this supplement summarize the major conclusions of a panel of experts in the field of hypertension with the aim of establishing strategies for better control of blood pressure in Spain. Conclusions are based on four major needs: to improve techniques for blood pressure measurements; to favor patients’ adherence to therapy; to clarify treatment goals and have physicians carry them out; and to optimize the antihypertensive treatment currently available. Various methods are proposed for establishing correct blood pressure values. These range from the training of the different health-care professionals involved (physicians, nurses, pharmacy employees etc.) to promoting wide-scale home monitoring with validated devices.

Patients’ compliance with medical therapy is one of the major problems in the treatment of chronic disease. A good doctor–patient relationship, clear treatment goals that are understood by the patient, and the use of simple treatment regimens are some of the proposed measures for achieving the final goals of the consensus.

Physicians involved in the treatment of hypertensive patients must have a clear knowledge of the treatment goals to be achieved in the individual patient and must consider not achieving them as a failure. Adequate professional training, knowledge of national and international guidelines on antihypertensive treatment and fighting against clinical inertia are important tools for achieving this goal.

Antihypertensive treatment must be both effective and simple. The use of a small number of daily tablets promotes adherence. Fixed drug combinations facilitate the achievement of this goal, allowing action over different therapeutic targets as well as minimizing the presence of drug-related adverse effects.

Please note the contents of this supplement are in Spanish.