679 Self-Blood Pressure Measurement Effect In Hypertension Control

Jesús Pablo González-Nuevo Quiñones1, Ángel Comas Fuentes1,2, Mª Luisa López González2, Rafael Marín Iranzo3, Nélida Díaz Fernández4, Mónica Álvarez Álvarez4.
1.- Centro de Salud de Otero (Oviedo) - Servicio de salud del Principado de Asturias
2.- Área de Medicina Preventiva de la Facultad de Medicina de la Universidad de Oviedo
3.- Servicio de Nefrología, Hospital Central de Asturias - Servicio de salud del Principado de Asturias
4- Centro de Salud de Otero (Oviedo) - enfermera becaria del proyecto
to study self-blood pressure measurement (SBPM) effect in hypertension (HT) control.
Clinical trial in primary health care level. A total of 109 patients with mild HT, not properly controlled at the office, were randomly selected into Intervention Group (IG) which was trained for SBPM and supplied validated digital blood-pressure monitors, and Control Group (CG) which continued being followed at the surgery. Blood pressure (BP) was controlled with 24-hours ambulatory blood pressure monitoring (ABPM), at the beginning,18 and 30 months after. BP with mean smaller than 130/80 mmHg by ABPM was considered under control. Drug consume by dairy defined dose (DDD), the index of psychological well-being (IB), physician visits due to HT and total visits to the health centre, other demographical variables and cardiovascular risk factors were recorded. Bivariate and multivariate analysis by multiple lineal regression and/or logistical regression were concluded.
the BP control was worse in the IG than in the CG, (OR ABPM=0,352; p=0,064) because of the BP at night (OR=0,286; p=0,021). For the BP during the day OR=0,650; p=0,423. The IG trends to meet less visits per year to follow HT (p=0,174), less total visits (p=0,362), consumes less drugs (DDD of 1,1 vs. 1,3; p=0,010) and has less IB (p=0,334).
We notice worse control in the SBPM group as a cause of the pressure at night. The impact over the assistential process is positive with a smaller drug consume and with a tendency to meet less physician visits.