Incredible forgetfulness of 86% of doctors when a patient goes into the office

High blood pressure is a major risk factor for public health. So have pressure under control this is the key. This involves something obvious: taking the patient’s blood pressure or asking the doctor to take it when they come into the office. What’s incredible is that many doctors do not comply with this basic clinical examination procedure.

An investigation entitled “Argentine Registry of Office Blood Pressure Measurements” carried out by the Argentine Society of Arterial Hypertension (SAHA) found that only 14 percent of health workers They measure their patients’ blood pressure.

“In Argentina, as in a number of countries, it is unknown how often are measurements taken? and recording blood pressure in those patients who present to the medical center. Our hypothesis is that there is medical inertia mainly in specialties related to cardiovascular diseases, which leads to a shortage of the first link in the diagnosis of high blood pressure,” says SAHA.

The study involved 9 institutions (2 public and 7 private) from 6 provinces of the country: Buenos Aires, Cordoba, Mendoza, Salta, Santa Cruz and Santa Fe. In total they were interviewed. 2982 consultations were conducted per day. Blood pressure was measured at 420 of 2982 consultations, and no differences were observed between men and women.

“He history of high blood pressure and cardiovascular disease (CVD) were the variables most associated with blood pressure measurement and recording. The presence of cancer has been associated with 50 percent less pressure measurement capabilities,” the message says.

arterial hypertension

In their findings, the researchers claim to have confirmed the hypothesis “very low prevalence of measurements and blood pressure recording in health care settings in Argentina.” They also claim that “there is an error when measuring pressure.” in favor of known hypertensive patients or people with a history of cardiovascular disease, as well as a tendency not to measure blood pressure in patients with a history of cancer.”

High blood pressure is the most common risk factor and is estimated to every second person In Argentina, it affects people over 30 years of age. “Unfortunately, the level of knowledge and control of this disease continues to be low. deficit. This deficiency is unacceptable if we consider it a disease relatively simple diagnosis and treatment with modern treatments,” they say.

The low level of knowledge and control is explained by several factorswhich include “patient-specific factors (non-adherence to treatment, drug side effects, lack of knowledge of risks), as well as treatment benefit, memory deficits, education and income level, medical encounter (consultation) time, availability of validated blood pressure monitors, and therapeutic inertia) And health care system (access to counseling, promotion of blood pressure measurement, health education).”

Regarding low blood pressure measurements in cancer patients, it is said that “it is possible that doctors omit it, linking cancer with short life expectancy and link the cardiovascular risk of hypertension in the long term. However, life expectancy for many tumor types has increased, and the prevalence of cardiovascular comorbidities, including hypertension, has increased and even worsened depending on the cancer therapy used.

The results of the study are lapidary for other medical specialties. “Surprisingly, we noticed that having diabetes was not associated with increased intake pressureAnd consistent with this finding, patients attending diabetes counseling were one of the groups in which their blood pressure was measured and recorded the least often (3.6%).”

To what do you attribute this omission? “Perhaps the concept of glycemic control (glucocentric) does not allow a diabetologist or general practitioner to approach the patient from global cardiovascular riskwhere blood pressure is of equal or greater importance than glycemic control, especially in these patients in whom the prevalence of hypertension in all its forms (daytime, nocturnal and resistant) is increasing,” they conclude.

“Medical and therapeutic inertia”

Marcos Marin, a cardiologist, high blood pressure expert and former president of SAHA, says that “while measuring blood pressure at a medical consultation is necessary, the bad news is that doctors do not measure blood pressure. Diagnosis is very simple and the vast majority of doctors do not do it. We are talking about medical and therapeutic inertia. Ideally, in addition to a pendant stethoscope, every doctor would have own blood pressure monitor, because the hospital is not going to give it to them and neither is the sanatorium. Every doctor should have a proven automatic blood pressure monitor. If this does not happen, another alternative is for the family to have a blood pressure monitor at home that can be changed between family members. It empowers the patient.”

Only 14 percent of doctors took a patient's blood pressure in the office.Only 14 percent of doctors took a patient’s blood pressure in the office.

“Hypertension is a major risk factor for stroke. This is the second risk factor for myocardial infarction. This is not observed in highly developed countries because hypertension is much better treated. Patients have a better degree of control. In the US or Germany, hypertension control rates range from 50 to 60 percent. We barely made it to 20 per cent– adds Marin.

“In Argentina, out of every 100 patients with hypertension, 40 do not even know it (where access to the healthcare system should be the most important factor). Of the remaining 60 who know they have hypertension, more than half are poorly controlled. Their blood pressure values ​​have not reached therapeutic goals (14/9 in our country), and for those who have already had the disease or suffer from diabetes, this goal falls (13/8),” explains the expert.

Why after 60 years It’s more likely that people become hypertensive? “Pressure depends on the volume of blood pumped out by the heart and peripheral resistance, which is how the arteries are positioned. And over the years the arteries become tougher, less flexible. Increasing rigidity leads to increased resistance. Thus, the prevalence of high blood pressure increases with increasing age. By age 60, 60 percent suffer from this. At 70, 70 percent and so on, it grows.”

How much does this affect eat less sodium and exercise to fight hypertension? “Having good habits helps prevent hypertension. appear later. But there is no study that concludes that if you engage in physical activity and eat less salt, you will never develop high blood pressure. Yes, these are two fundamental principles for everyone, and especially for people with hypertension. Sodium consumption in Argentina is at 12 grams of salt per day. In the province of Buenos Aires, bakeries were required by law to bake bread with less salt, causing the average to drop from 12 to 11. When what is recommended for the population should be 5 or 6 grams of salt per day. “We are consuming twice as much as we should be healthy.”

In conclusion, the cardiologist reminded that “just as it is very bad to eat a lot of sodium, it is very healthy to eat a lot of sodium.” lots of potassium to counteract. If you eat much more potassium than salt, it will have a huge impact on your health. Potassium is found in tomatoes, kiwis and bananas. I tell my patients that you can indulge in a shortbread sandwich or a slice of pizza once in a while, but you should consume plenty of potassium afterwards.”

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