Comparison of arterial pressure values measured in office and by ABPM in patients with artery hypertension and with or without backgrounded combididity

Cilj istraživanja: Istražiti i prikazati raspodjelu ispitanika koji boluju samo od hipertenzije i ispitanika koji boluju od hipertenzije i pridruženih komorbiditeta po spolu. Usporediti te dvije skupine po dobi, ITM-u te broju antihipertenzivnih lijekova u terapiji. Usporediti skupine prema arterijskim tlakovima mjerenim u ordinaciji i KMAT-om. Prikazati učestalost pojedinih komorbiditeta u multimorbiditetnih bolesnika. Materijali i metode: Provedeno je retrospektivno presječno istraživanje u koje su uključene dvije skupine bolesnika s arterijskom hipertenzijom kao osnovnom bolešću. U prvoj skupini bili su ispitanici koji su bolovali samo od hipertenzije te ih je bilo 68, dok su u drugoj skupini bili ispitanici s hipertenzijom i pridruženim komorbiditetima (multimorbiditetni ispitanici) te ih je bilo 58. Podatci su prikupljeni iz elektronskih medicinskih kartona u osam specijalističkih ordinacija obiteljske medicine medicine Doma zdravlja Splitsko-dalmatinske županije s područja grada Splita. Istraživanje je obuhvatilo sve bolesnike kojima je u razdoblju od 1. rujna 2018. do 1. travnja 2019. godine napravljeno 24 - satno kontinuirano mjerenje arterijskog tlaka (KMAT). Rezultati: U skupini pacijenata koji su bolovali isključivo od arterijske hipertenzije udio žena iznosio je 64,7 %, dok je ispitanika muškog spola bilo tek 35,3 %. Nasuprot tome, u skupini hipertoničara s komorbiditetima udio žena bio je nešto manji (55,2 %). Pacijenata muškog spola u istoj skupini bilo je 44,8 %. Hipertoničari s komorbiditetima u prosjeku su 7,4 godine stariji od pacijenata koji boluju samo od arterijske hipertenzije (p = 0,05). U skupini hipertoničara s komorbiditetima 19 (32,8 %) ispitanika uzimalo je jedan, 28 (38,2 %) dva te 11 (19 %) tri ili više lijekova. Nasuprot tome, u skupini hipertoničara 43 (63,2 %) ispitanika uzimalo je jedan, 17 (25 %) dva, a 8 (11,8 %) tri ili više lijekova u kroničnoj antihipertenzivnoj terapiji (p = 0,003). U pacijenata koji boluju od arterijske hipertenzije najčešći komorbiditeti bili su: dislipidemija (23,8 %), šećerna bolest (17,5 %) i depresija (8,7 %). U ovom je istraživanju najrjeđi komorbiditet bilo kronično bubrežno zatajenje (0,8 %), dok CV incidenata uopće nije bilo (0 %). Zaključak: U ovoj studiji pokazano je kako hipertoničari s komorbiditetima imaju u prosjeku manji dijastolički tlak mjeren u ordinaciji od ispitanika koji boluju samo od hipertenzije te da su multimorbiditetni ispitanici u prosjeku stariji od ispitanika koji boluju samo od hipertenzije. Također, dokazano je da multimorbiditetni hipertoničari u prosjeku imaju više antihipertenzivnih lijekova u terapiji od ispitanika koji boluju samo od hipertenzije. Razlike ITM-a među ispitivanim skupinama nije bilo.Objectives: To investigate and present the distribution of subjects who are suffering from arterial hypertension and those with arterial hypertension and associated comorbidities by sex. Compare these two groups by age, ITM, and the number of antihypertensive drugs used in chronic therapy. Compare the groups according to the arterial pressure measured in the clinic and measured using ABPM. Finally, to show the frequency of individual comorbidities in multimerbidity patients. Patients and methods: Retrospective cross-sectional research was conducted involving two groups of patients with arterial hypertension as primary disease. In the first group, there were only patients with arterial hypertension (68 patients), while in the second group were patients with arterial hypertension and associated comorbidities (58 patients). Data was collected from electronic medical charts in eight specialist ordination of the family medicine of the Health Center of the Split – dalmatian County, City of Split. The study encompassed all patients with a 24 - hour continuous measurement of arterial pressure (ABPM) in the period from September 1st, 2018 to April 1st, 2019. Results: In a group of patients suffering from arterial hypertension alone, the proportion of women was 64.7 %, while the share of male subjects was only 35.3 %. In contrast, in the group of hypertension with comorbidities, the proportion of women was slightly smaller (55.2 %). The share of male patients in the same group was 44.8 %. Patients with hypertension and comorbidities are 7.4 years older than patients suffering only from arterial hypertension (p = 0.05). In the group of hypertensives with comorbidities 19 of the subjects (32.8 %) received one drug, 28 subjects (38.2 %) two drugs and 11 subjects (19 %) three or more drugs. In contrast, in the group of hypertensives 43 subjects recieved one drug (63.2 %), 17 subjects two drugs (25 %) and 8 subjects (11.8 %) three or more drugs in chronic antihypertensive therapy (p = 0.003). Among patients with arterial hypertension, the most common comorbidities were: dyslipidemia (23.8 %), diabetes mellitus type 2 (17.5 %) and depression (8.7 %). In this study, the rarest comorbidity was chronic kidney failure (0.8 %), while CV incidents were not seen at all (0 %). Conclusion: In this study it has been shown that patients with arterial hypertension and comorbidities have an average diastolic pressure lower than those with solely arterial hypertension and that multimorbidity patients are on average older than those who are suffering from hypertension alone. It has also been demonstrated that patients with multimorbidity and hypertension have on average more antihypertensive drugs in chronic therapy than subjects with arterial hypertension alone. There were no BMI (Body Mass Index) differences among the investigated groups