2026-06-14T00:34:58Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/229312024-11-28T21:10:54Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967

00925njm 22002777a 4500 dc Unda Villafuerte, Fabian author Llobera Cànaves, Joan author Lorente Montalvo, Patricia author Moreno Sancho, Maria Lucia author Oliver Oliver, Bartolome author Bassante Flores, Patricia author Estela Mantolan, Andreu author Pou Bordoy, Joan author Rodriguez Ruiz, Tomas author Requena Hernandez, Ana author Leiva Rus, Alfonso author Torrent Quetglas, Maties author Coll Benejam, Josep Maria author D'Agosto Forteza, Pilar author Rigo Carratalá, Fernando author Medichy Grp author 2020-04 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). 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. 10.1097/MD.0000000000019769 1536-5964 0025-7974 Medicine http://hdl.handle.net/20.500.13003/11042 32332617 L631733981 2-s2.0-85084577392 https://hdl.handle.net/20.500.12105/22931 544715800028 Blood pressure control Hypertension Low sodium diet Physical exercise Self-management Self-monitoring 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