Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/11042
Effectiveness of a multifactorial intervention, consisting of self-management of antihypertensive medication, self-measurement of blood pressure, hypocaloric and low sodium diet, and physical exercise, in patients with uncontrolled hypertension taking 2 or more antihypertensive drugs The MEDICHY study
Identifiers
ISSN: 0025-7974
eISSN: 1536-5964
WOS ID: 000544715800028
Scopus EID: 2-s2.0-85084577392
PMID: 32332617
Embase PUI: L631733981
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Unda Villafuerte, Fabian












Publication date
2020-04Document type
research articleCitation
Unda Villafuerte F, Llobera Canaves J, Lorente Montalvo P, Moreno Sancho Maria L, Oliver Oliver B, Bassante Flores P, et al. Effectiveness of a multifactorial intervention, consisting of self-management of antihypertensive medication, self-measurement of blood pressure, hypocaloric and low sodium diet, and physical exercise, in patients with uncontrolled hypertension taking 2 or more antihypertensive drugs The MEDICHY study. Medicine (Baltimore). 2020 Apr;99(17):e19769.Abstract
Introduction: High blood pressure is the leading modifiable risk factor for cardiovascular disease, and is associated with high morbidity and mortality and with significant health care costs for individuals and society. However, fewer than half of the patients with hypertension receiving pharmacological treatment have adequate blood pressure control. The main reasons for this are therapeutic inertia, lack of adherence to treatment, and unhealthy lifestyle (i.e., excess dietary fat and salt, sedentary lifestyle, and overweight). Cardiovascular risk and mortality are greater in hypertensive patients who are receiving treatment but have suboptimal control of blood pressure. Methods/Design: This is a multicentre, parallel, 2-arm, single-blind (outcome assessor), controled, cluster-randomized clinical trial. General practitioners and nurses will be randomly allocated to the intervention group (self-management of antihypertensive medication, self-measurement of blood pressure, hypocaloric and low sodium diet, and physical exercise) or the control group (regular clinical practice). A total of 424 patients in primary care centers who use 2 or more antihypertensive drugs and blood pressure of at least 130/80 during 24-hambulatory blood pressure monitoring will be recruited. The primary outcome is systolic blood pressure at 12 months. The secondary outcomes are blood pressure control (<140/90 mm Hg); quality of life (EuroQol 5D); direct health care costs; adherence to use of antihypertensive medication; and cardiovascular risk (REGICOR and SCORE scales). Discussion: This trial will be conducted in the primary care setting and will evaluate the impact of a multifactorial intervention consisting of self-management of blood pressure, antihypertensive medications, and lifestyle modifications (hypocaloric and low sodium diet and physical exercise).
Publisher version
https://dx.doi.org/10.1097/MD.0000000000019769Keywords
blood pressure controlhypertension
low sodium diet
physical exercise
self-management
self-monitoring
MeSH
AgedCluster Analysis
Adult
Humans
Life Style
Diet, Sodium-Restricted
Blood Pressure Determination
Hypertension
Middle Aged
Blood Pressure
Male
Self-Management
Treatment Adherence and Compliance
Female
Risk Factors
Treatment Outcome
Antihypertensive Agents
Caloric Restriction
Exercise
DeCS
AntihipertensivosEjercicio Físico
Resultado del Tratamiento
Automanejo
Femenino
Cumplimiento y Adherencia al Tratamiento
Masculino
Restricción Calórica
Hipertensión
Factores de Riesgo
Determinación de la Presión Sanguínea
Presión Sanguínea
Humanos
Persona de Mediana Edad
Dieta Hiposódica
Estilo de Vida
Anciano
Adulto
Análisis por Conglomerados
This item appears in following Docusalut collections
Atención Primaria de Mallorca - APMALL > Comunicación científicaInstituto de Investigación Sanitaria Islas Baleares - IDISBA > Comunicación científica
Área de Salud de Menorca - ASME > Comunicación científica