Identifying masked uncontrolled hypertension in the community pharmacy setting

Publication Type:
Journal Article
Blood Pressure Monitoring, 2015, 20 (3), pp. 138 - 143
Issue Date:
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© 2015 Wolters Kluwer Health, Inc. Masked uncontrolled hypertension (MUCH) is associated with an increased cardiovascular risk. This condition is frequent in the community pharmacy (i.e., CP-MUCH), but there is no evidence on the factors associated with its presence in that setting. The aim of this analysis was to explore these factors. A sample of 98 treated hypertensive patients from the MEPAFAR study, with normal community pharmacy blood pressure (CPBP <135/85 mmHg), were analyzed. Blood pressure (BP) was also measured at home (4 days) and monitored for 24 h. CP-MUCH was identified when either ambulatory (daytime) or home BP averages were equal to or higher than 135/85 mmHg. A multivariate logistic regression analysis was carried out to identify the factors associated with CP-MUCH. The prevalence of CP-MUCH tends to be higher as systolic and diastolic CPBP increase, reaching 47% in patients with both systolicand diastolic CPBP equal to or higher than 123 mmHg and 79 mmHg, respectively.The multivariate regression analysis showed only systolic CPBP as an independent factor of CP-MUCH [≥123 mmHg: odds ratio=16.46 (P=0.012); from 115 to 122.9 mmHg: odds ratio=10.74 (P=0.036); systolic CPBP <115 mmHg as the reference]. Further assessment, using ambulatory and/or home BP monitoring, is recommended in patients with normal CPBP, but systolic CPBP equal to or higher than 115 mmHg. A more feasible approach would be evaluating patients with systolic CPBP equal to or higher than 123 mmHg and diastolic CPBP equal to or higher than 79 mmHg.
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