Evaluación de la efectividad de un programa de apoyo para pacientes con Hipertensión Arterial en atención primaria: un estudio observacional en población ecuatoriana

Abstract

Introduction and objective: Primary care is one of the most profitable strategies to lower morbidity, disability and premature mortality in arterial hypertension (HTN).  In Ecuador, the Comprehensive Health Care Model (MAIS) was implemented at the beginning of 2010.  The objective of this work is to identify the metabolic behavior and its complications in patients diagnosed with hypertension under this model from 2010 to 2017, in a first-level medical center located in Quito-Ecuador.

Materials and methods: An observational study, carried out in 141 patients with diagnosis of hypertension treated in a Primary Care Center.  The inclusion criteria were being over 18 years old, diagnosis of hypertension and having regular laboratory tests.  The data collected included sociodemographic and metabolic values in patients with 1 to 8 years of treatment at the medical center.  Statistical analysis was performed with IBM SPSS Statistics (version 23).                                                  

Results: Of all the patients studied, the control was adequate in 112 (79.43%).  They are mostly women (80.14%).  Metabolic conditions such as lipid profile are better controlled at the end of the observation in men (total Cholesterol F:189.9 vs M:168.46 mg/dl; HDL-c F:72.84 vs M:61.14 mg/dl; c-LDL F: 85.95 vs M: 77.78 mg/dl; Triglycerides F: 150.62 vs M: 148 mg/dl); the most important outcome was a lower incidence of plaque in carotid echo, normal ankle-brachial index and a low cardiovascular risk.

Conclusion: This Primary Care Center has implemented a program based on the Comprehensive Health Care Model (MAIS), for patients with hypertension through the construction of a support network.  It has been effective in controlling blood pressure, risk factors and its complications.