Characteristics Associated with Uncontrolled Blood Pressure Among Portuguese Primary Care Patients with Type 2 Diabetes

Detalhes bibliográficos
Autor(a) principal: Rosendo, Inês
Data de Publicação: 2017
Outros Autores: Santiago, Luiz Miguel, Marques, Margarida
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8321
Resumo: Introduction: Determine whether socio-demographic, habits and risk factors are associated with a better tensional control in type 2 diabetes in primary care patients in order to identify a specific target population for compensatory interventions improving diabetes control and reducing its morbi-mortality.Material and Methods: Cross-sectional study in primary care. Randomized type 2 diabetes patient data collection by their volunteer family doctors, proportionally stratified from the 5 Portuguese continental regions. Variables: blood pressure, age, gender, education, diabetes duration, HbA1c, smoking habits, weight, waist circumference, physical activity and adherence to medication. Bivariate and logistic regression analysis to evaluate each measured variable’s independent association with uncontrolled blood pressure (≥ 140/90).Results: 709 patients were included in the study, 60.2% men, mean age 66.12 ± 10.47 years. In logistic regression analysis, the factors independently associated to uncontrolled BP were lower education (p = 0.014), shorter diabetes duration (p = 0.002), higher waist circumference (p < 0.001), higher pulse pressure (p < 0.001), higher physical activity level (p = 0.043) and being a smoker (p < 0.001).Discussion: The main limitations are the fact that the sample was not totaly random and included only primary care patients, a possible inter-observer bias and being a cross-sectional study, thus not providing information on temporal relation or causality.Conclusion: The sub-group of people with diabetes identified to have worse tensional control should have a different and more intensive approach in primary care. We recommend further longitudinal and population based confirmatory research.
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spelling Characteristics Associated with Uncontrolled Blood Pressure Among Portuguese Primary Care Patients with Type 2 DiabetesFatores Associados a Tensão Arterial Não Controlada em Pessoas com Diabetes Tipo 2 Seguidas nos Cuidados de Saúde Primários em PortugalBlood PressureBlood Pressure DeterminationDiabetes MellitusType 2PortugalPrimary Health CareCuidados de Saúde PrimáriosDeterminação da Pressão ArterialDiabetes Mellitus Tipo 2PortugalPressão ArterialIntroduction: Determine whether socio-demographic, habits and risk factors are associated with a better tensional control in type 2 diabetes in primary care patients in order to identify a specific target population for compensatory interventions improving diabetes control and reducing its morbi-mortality.Material and Methods: Cross-sectional study in primary care. Randomized type 2 diabetes patient data collection by their volunteer family doctors, proportionally stratified from the 5 Portuguese continental regions. Variables: blood pressure, age, gender, education, diabetes duration, HbA1c, smoking habits, weight, waist circumference, physical activity and adherence to medication. Bivariate and logistic regression analysis to evaluate each measured variable’s independent association with uncontrolled blood pressure (≥ 140/90).Results: 709 patients were included in the study, 60.2% men, mean age 66.12 ± 10.47 years. In logistic regression analysis, the factors independently associated to uncontrolled BP were lower education (p = 0.014), shorter diabetes duration (p = 0.002), higher waist circumference (p < 0.001), higher pulse pressure (p < 0.001), higher physical activity level (p = 0.043) and being a smoker (p < 0.001).Discussion: The main limitations are the fact that the sample was not totaly random and included only primary care patients, a possible inter-observer bias and being a cross-sectional study, thus not providing information on temporal relation or causality.Conclusion: The sub-group of people with diabetes identified to have worse tensional control should have a different and more intensive approach in primary care. We recommend further longitudinal and population based confirmatory research.Introdução: A hipertensão arterial está associada a maior morbimortalidade na diabetes tipo 2. É assim importante identificar quais as características socio demográficas, hábitos e fatores de risco das pessoas com diabetes tipo 2 que estão associadas a descontrolo tensional de modo a intervir de forma ajustada nesta população.Material e Métodos: Estudo observacional transversal nos cuidados de saúde primários com recolha de dados de pessoas com diabetes tipo 2 aleatorizadas pelos seus médicos de família, estratificados proporcionalmente pelas cinco regiões de saúde de Portugal continental. Variáveis: tensão arterial, idade, sexo, formação, duração da diabetes, HbA1c, hábitos tabágicos, peso, perímetro abdominal, nível de atividade física e adesão à medicação. Análise bivariada e por regressão logística para avaliar a associação independente de cada variável com descontrolo tensional (tensão arterial ≥ 140/90).Resultados: Estudados 709 doentes, 60,2% homens, idade média 66,12 ± 10,47 anos. Após análise de regressão logística, verificou-se que os fatores independentemente associados a não controlo da tensão arterial foram a menor formação académica (p = 0,014), a menor duração da diabetes (p = 0,002), o maior perímetro abdominal (p < 0,001), a maior pressão de pulso (p < 0,001) e o maior nível de atividade física (p = 0,043), assim como o facto de ser fumador (p < 0,001).Discussão: As principais limitações do estudo são o facto da amostra não ser totalmente aleatória e incluir apenas frequentadores dos cuidados primários, um possível vies inter-observador e o facto de ser um estudo transversal e não poder deduzir causalidade.Conclusão: O sub-grupo de pessoas com diabetes tipo 2 identificadas como tendo maior associação a pior controlo tensional deveriam ser alvo de uma abordagem diferente e mais intensiva nos cuidados de saúde primários em relação a este fator de risco. Recomendamos estudos longitudinais e populacionais para confirmar estes resultados.Ordem dos Médicos2017-03-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfimage/jpegapplication/zipapplication/zipapplication/mswordimage/jpeghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8321oai:ojs.www.actamedicaportuguesa.com:article/8321Acta Médica Portuguesa; Vol. 30 No. 3 (2017): March; 197-204Acta Médica Portuguesa; Vol. 30 N.º 3 (2017): Março; 197-2041646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8321https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8321/4969https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8321/5136https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8321/8815https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8321/8841https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8321/8842https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8321/8976https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8321/9142Direitos de Autor (c) 2017 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessRosendo, InêsSantiago, Luiz MiguelMarques, Margarida2022-12-20T11:05:29Zoai:ojs.www.actamedicaportuguesa.com:article/8321Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:34.602792Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Characteristics Associated with Uncontrolled Blood Pressure Among Portuguese Primary Care Patients with Type 2 Diabetes
Fatores Associados a Tensão Arterial Não Controlada em Pessoas com Diabetes Tipo 2 Seguidas nos Cuidados de Saúde Primários em Portugal
title Characteristics Associated with Uncontrolled Blood Pressure Among Portuguese Primary Care Patients with Type 2 Diabetes
spellingShingle Characteristics Associated with Uncontrolled Blood Pressure Among Portuguese Primary Care Patients with Type 2 Diabetes
Rosendo, Inês
Blood Pressure
Blood Pressure Determination
Diabetes Mellitus
Type 2
Portugal
Primary Health Care
Cuidados de Saúde Primários
Determinação da Pressão Arterial
Diabetes Mellitus Tipo 2
Portugal
Pressão Arterial
title_short Characteristics Associated with Uncontrolled Blood Pressure Among Portuguese Primary Care Patients with Type 2 Diabetes
title_full Characteristics Associated with Uncontrolled Blood Pressure Among Portuguese Primary Care Patients with Type 2 Diabetes
title_fullStr Characteristics Associated with Uncontrolled Blood Pressure Among Portuguese Primary Care Patients with Type 2 Diabetes
title_full_unstemmed Characteristics Associated with Uncontrolled Blood Pressure Among Portuguese Primary Care Patients with Type 2 Diabetes
title_sort Characteristics Associated with Uncontrolled Blood Pressure Among Portuguese Primary Care Patients with Type 2 Diabetes
author Rosendo, Inês
author_facet Rosendo, Inês
Santiago, Luiz Miguel
Marques, Margarida
author_role author
author2 Santiago, Luiz Miguel
Marques, Margarida
author2_role author
author
dc.contributor.author.fl_str_mv Rosendo, Inês
Santiago, Luiz Miguel
Marques, Margarida
dc.subject.por.fl_str_mv Blood Pressure
Blood Pressure Determination
Diabetes Mellitus
Type 2
Portugal
Primary Health Care
Cuidados de Saúde Primários
Determinação da Pressão Arterial
Diabetes Mellitus Tipo 2
Portugal
Pressão Arterial
topic Blood Pressure
Blood Pressure Determination
Diabetes Mellitus
Type 2
Portugal
Primary Health Care
Cuidados de Saúde Primários
Determinação da Pressão Arterial
Diabetes Mellitus Tipo 2
Portugal
Pressão Arterial
description Introduction: Determine whether socio-demographic, habits and risk factors are associated with a better tensional control in type 2 diabetes in primary care patients in order to identify a specific target population for compensatory interventions improving diabetes control and reducing its morbi-mortality.Material and Methods: Cross-sectional study in primary care. Randomized type 2 diabetes patient data collection by their volunteer family doctors, proportionally stratified from the 5 Portuguese continental regions. Variables: blood pressure, age, gender, education, diabetes duration, HbA1c, smoking habits, weight, waist circumference, physical activity and adherence to medication. Bivariate and logistic regression analysis to evaluate each measured variable’s independent association with uncontrolled blood pressure (≥ 140/90).Results: 709 patients were included in the study, 60.2% men, mean age 66.12 ± 10.47 years. In logistic regression analysis, the factors independently associated to uncontrolled BP were lower education (p = 0.014), shorter diabetes duration (p = 0.002), higher waist circumference (p < 0.001), higher pulse pressure (p < 0.001), higher physical activity level (p = 0.043) and being a smoker (p < 0.001).Discussion: The main limitations are the fact that the sample was not totaly random and included only primary care patients, a possible inter-observer bias and being a cross-sectional study, thus not providing information on temporal relation or causality.Conclusion: The sub-group of people with diabetes identified to have worse tensional control should have a different and more intensive approach in primary care. We recommend further longitudinal and population based confirmatory research.
publishDate 2017
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8321/5136
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8321/8815
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8321/8976
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dc.rights.driver.fl_str_mv Direitos de Autor (c) 2017 Acta Médica Portuguesa
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 30 No. 3 (2017): March; 197-204
Acta Médica Portuguesa; Vol. 30 N.º 3 (2017): Março; 197-204
1646-0758
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