Antoni Dalfó-Baqué

• M.D. PhD.
• Medical Doctor at Institut Català de la Salut, Barcelona

Background: The optimal schedule for self-monitoring home BP (SMHBP) readings is enormously important in the diagnosis of different phenotypes related to hypertension. The aim of this study was to determine the prognostic capacity of a 3-day SMHBP schedule when using or suppressing the first-day measurements in compiling the results. Methods: A...

Introduction: Nurses play an important part in the education of patients with HF. To prepare patients with HF for self-care maintenance behaviours, nurses must have knowledge of basic self-care maintenance principles. Aim study: The aim of this study was to determine the degree of knowledge of primary care (PC) nurses on the principles of self-m...

Background: Right bundle branch block (RBBB) is among the most common electrocardiographic abnormalities. Objectives: To establish the prevalence and incidence of RBBB in the general population without cardiovascular events (CVE) and whether RBBB increases cardiovascular morbidity and mortality compared with patients with a normal electrocardiogram...

Two aspects arise concerning the use of self-measured blood pressure monitoring to diagnose white-coat hypertension (WCH): the presence of target organ damage (TOD) and the normal cut-off threshold. This study aims to evaluate the cardiovascular risk of WCH according to different self-measured blood pressure normal cut-off thresholds and the influe...

Introduction: Ambulatory blood pressure monitoring (ABPM) is fundamental to diagnosing and monitoring arterial hypertension (HTN), yet it is not known how effective training could be in improving knowledge of ABPM. Purpose: The purpose of this study was to evaluate ABPM knowledge before and after a training activity. Methodology: A before-and-aft...

Objective: To evaluate the effect of effervescent paracetamol on office and ambulatory blood pressure (BP) compared with noneffervescent paracetamol in hypertensive patients. Design: This was a multicenter open crossover randomized clinical trial. Setting: Primary care centers in Catalonia and the Basque Country. Participants: Inclusion crit...

http://gestorweb.camfic.cat//uploads/ITEM_7309_ART_490.pdf http://www.butlleti.cat/ca/Vol34/iss3/2 Resum Introducció. L’objectiu fou avaluar la possible relació entre bloqueig de branca dreta (BBD), tant complet com incomplet i risc de desenvolupar malaltia cardiovascular, a partir de la revisió bibliogràfica fins al març de 2015. Material i mè...

Background: Paracetamol's solubility is achieved by adding to the excipient sodium salts, either as bicarbonate, carbonate or citrate. As the relationship between salt and hypertension is well known, due to the sodium content it has raised a hypothesis that may interfere with the control of that risk factor. Therefore, the objective of this study...

To assess the effectiveness of an intervention to promote standardized arm circumference measurement as way to choose appropriate cuff size to measure blood pressure.

Objective To assess the knowledge of the hypertensive patients about their hypertension and their relation to its control. Material and methods Cross-sectional study among 400 hypertensive patients, all over 18 years, selected from 50 primary-care centres, who responded to an hypertension-related survey. Included variables were survey items, age,...

Objective To find whether better compliance with the indicators of procedure of a hypertension monitoring programme guarantees better control in the final blood pressure figures. Design Descriptive cross-sectional study. Setting Gòtic Area Health Centre, Barcelona. Patients Annual audit through random sampling of the computerised records of all...

Objective To determine the protagonism of the medical and nursing staff in the diagnosis and observation of hypertense patients in a primary care team. Design Cross-sectional descriptive study. Setting Urban primary care team. Participants Two random samples, with 325 clinical histories, of the hypertense patients under observation in the centre...

Objective To evaluate the measurement properties of the Hypertension Quality of Life (HQALY) questionnaire, under normal clinical practice conditions, and the relationship between quality of life and clinical variables in patients with hypertension. Design Observational, prospective and multi-centred study. Setting 92 primary care centres in Spai...

Background The prevalence of chronic kidney disease (CKD) in Spain is higher than 7%. Its early diagnóstico can help to delay its progression. Glomerular filtration rate (GFR) based on serum creatinine (SC) is calculated in primary care (PC) to identify CKD.Objectives To compare GFR by MDRD-4 and CKD-EPI equations obtained from clinical records (CR...

Background To determine the prognostic value of various self-blood pressure (BP) monitoring (SBPM) cutoff at the time of diagnosis.Methods Cohort of 466 newly diagnosed and never-treated hypertensive patients. At baseline and at 1 year, the patients underwent a physical examination, clinic BP (CBP), SBPM, and ambulatory BP monitoring (ABPM), fastin...

White coat effect (WCE) is one of the main bias that can affect office blood pressure (BP) measurement. Therefore, it is a factor must be considered in hypertensives to avoid mistakes in diagnosis and/or treatment. Employment of automated office BP (AOBP) devices could diminish that effect. Two studies were designed with the objective of evaluating...

Objetivo Establecer la asociación entre el mantenimiento de niveles de presión arterial sistólica (PAS) normal-baja y normal-alta con el riesgo de recurrencia del accidente vascular cerebral (AVC). Emplazamiento Estudio multicéntrico: 695 centros de 35 países. Diseño Análisis observacional post hoc del estudio Prevention Regime for Effectively Av...

Objetivo Comparar estrategias de medida de la presión arterial (PA) en la consulta o en el domicilio del paciente y su repercusión en la clasificación y el control. Emplazamiento Clínicas de atención primaria que atienden a veteranos de Estados Unidos (Durham Veterans Affairs Medical Center). Diseño Análisis secundario de un ensayo clínico (EC) a...

Background: Cardiovascular (CV) disease mortality is increased in diabetes mellitus (DM) and metabolic syndrome (MS), conditions which share CV risk factors. Aim: The purpose of this study was to assess understanding of CV risk by patients with DM and/or MS diagnosed less than 1 year before and seen in primary care. Perception by these patients...

Objetivo Evaluar si los antagonistas de los receptores de la angiotensina (ARA) están relacionados con la presencia de cáncer. Diseño Metaanálisis de ensayos clínicos aleatorizados (ECA) de estos fármacos. Fuentes de datos Medline, Scopus (incluyendo Embase), Registro Central de Ensayos Controlados Cochrane, Base de datos de Revisiones Sistemátic...

Self-blood pressure (BP) measurement (SBPM) and ambulatory BP measurement (ABPM) are suitable for the isolated clinical hypertension (ICH) or 'white-coat' hypertension diagnosis. However, patients with ICH have a different cardiovascular risk according to the measurement technique used for the diagnosis. To describe baseline cardiovascular risk of...

Objetivo Comparar los beneficios y los riesgos del tratamiento con inhibidores de la enzima convertidora de la angiotensina (IECA), el tratamiento con antagonistas de los receptores de la angiotensina II (ARA-II) y la combinación de ambos, añadido al tratamiento habitual de adultos con cardiopatía isquémica estable y función sistólica preservada....

Objetivo Establecer, en pacientes diabéticos tipo 2 con riesgo elevado de presentar acontecimientos cardiovasculares, si una estrategia antihipertensiva consistente en reducir la presión arterial sistólica (PAS) por debajo de valores de 120 mmHg comparada con la estrategia clásica, PAS < 140 mmHg, reduce los episodios cardiovasculares mayores. Emp...

FUNDAMENTALS AND OBJECTIVE: Electrocardiographic voltage criteria are the preferred method for diagnosis of left ventricular hypertrophy (LVH) in Primary Health Care (PHC). Several of these have been described as major adverse cardiovascular events (MACE) predictors. The aim of this study was to analyse the relationship between MACE occurrence in a...

Objective: To assess the knowledge about the health condition and the global cardiovascular (CV) risk level of patients diagnosed with diabetes mellitus (DM) in the previous year in Primary Care (PC) settings. Design and Method: Epidemiologic, cross-sectional, nationwide, multi-center study. Results: In this study 139 physicians have recruited 673...

Objetivo Valorar la relación existente entre el nivel de ingesta habitual de sal y los accidentes vasculares cerebrales (AVC) o la enfermedad cardiovascular total. Diseño Revisión sistemática y metaanálisis de estudios prospectivos publicados de 1966 a 2008. Fuentes de datos Medline (1966-2008), Embase (desde 1988), AMED (desde 1985), CINAHL (des...

IntroductionFew studies have evaluated crucial features, such as diagnosis and follow-up, with specific indicators. This study has aimed to evaluate the diagnosis, follow-up and control of arterial hypertension in Spain, using established indicators.

Antecedentes: El deterioro de la función renal se ha asociado con un incremento de la morbimortalidad cardiovascular. El objetivo del estudio fue analizar la asociación del filtrado glomerular (FG) basal, según las fórmulas de Cockcroft- Gault y MDRD, con la incidencia de eventos cardiovasculares (ECV) en una cohorte de personas hipertensas seguida...

A decrease in renal function is associated with cardiovascular morbidity and mortality. The aim of this study was to analyse the association of cardiovascular morbidity and mortality with baseline glomerular filtration rate (GFR), calculated according to the Cockcroft-Gault and MDRD formulas, with the incidence of major adverse cardiovascular event...

Background: Renal function decrease is associated with cardiovascular morbidity and mortality. The aim was to analyze the association of cardiovascular morbidity and mortality with baseline glomerular filtration rate (GFR), according Cockcroft-Gault and MDRD formulas, with incidence of major adverse cardiovascular events (MACEs) in a cohort of hype...

Objetivo Desarrollar una nueva ecuación de estimación del filtrado glomerular (FG): la CKD-EPI (the Chronic Kidney Disease Epidemiology Collaboration). Emplazamiento Estudios de investigación y poblaciones clínicas con disponibilidad del FG y población americana del NHANES (National Health and Nutrition Examination Survey), del 1999 al 2006. Dise...

Objetivo Comparar, en pacientes hipertensos no diabéticos, el control habitual y una reducción más estricta de la presión arterial sistólica (PAS). Emplazamiento 44 centros de Italia. Diseño Ensayo clínico (EC) aleatorizado, abierto, con seguimiento medio de 2 años. Población de estudio 1.111 pacientes hipertensos no diabéticos, con PAS ≥ 150 mm...

Objetivo Evaluar el efecto de 4 dietas, que contienen diferente proporción de macronutrientes, en la pérdida de peso. Diseño Ensayo clínico, con distribución aleatoria y un seguimiento medio de 2 años. Emplazamiento Centros hospitalarios y universitarios de Estados Unidos. Población de estudio Un total de 811 adultos de 30-70 años de edad, con u...

Objetivo Evaluar el efecto de una intervención educativa en la competencia clínica de los médicos de familia (MF) y determinar el impacto en la función renal de sus pacientes con diabetes mellitus tipo 2 (DM2). Diseño Ensayo controlado, aleatorizado por agregados (clusters), con un seguimiento de 12 meses. Emplazamiento Un total de 23 centros de...

Objetivo Evaluar si la combinación de un inhibidor de la enzima de conversión de angiotensina (IECA) y un bloqueador de los canales del calcio (BCC) es más efectiva que la combinación de un diurético tiazídico (DT) y un IECA en la reducción de episodios cardiovasculares (CV), mortales o no, en pacientes hipertenso de alto riesgo. Emplazamiento Un...

Objetivo Establecer si las reducciones de riesgo obtenidas para la enfermedad microvascular y macrovascular mediante un mejor control de la presión arterial (PA) persistían en los pacientes tras la finalización del ensayo clínico (EC) UKPDS. Emplazamiento Veinte centros de Inglaterra, Escocia e Irlanda del Norte. Diseño Estudio de seguimiento a 1...

Objetivo Evaluar el papel de la reducción de la frecuencia cardíaca con bloqueadores betaadrenérgicos (BB) en el riesgo de acontecimientos cardiovasculares en pacientes con hipertensión arterial (HTA). Fuentes de datos Se realizó una búsqueda sistemática de ensayos clínicos aleatorizados (ECA) de tratamientos antihipertensivos en humanos, y metaan...

Numerous hospital studies have shown that different left ventricular (LV) geometric patterns have different effects on cardiovascular risk. The aims of this study were to estimate the risk of major adverse cardiovascular events (MACEs) in hypertensive patients seen in primary care and to identify any association with LV geometric pattern. In total,...

To determine the attitude to therapy of primary care staff in view of the lack of reduction in blood pressure. To describe the most commonly used antihypertensives. Descriptive, longitudinal, retrospective study during the year 2001. Primary care, Spain. We analysed 990 hypertensive patients from 12 health centres picked from the 31 participants in...

En los pacientes con enfermedad vascular o diabetes mellitus (DM) con alto riesgo y sin insuficiencia cardíaca, los inhibidores de la enzima conversiva de la angiotensina (IECA) reducen la morbimortalidad de causa cardiovascular, pero el papel de los antagonistas de los receptores de la angiotensina II (ARA-II) en estos pacientes es desconocido. O...

Objetivo Determinar la asociación entre cáncer y los fármacos antihipertensivos más comúnmente utilizados. Fuentes de datos Búsqueda sistemática de ensayos clínicos aleatorizados (ECA) de tratamientos antihipertensivos en humanos en: MEDLINE (de 1966 a junio 2007), CINAHL (de 1982 a junio 2007) y la web de Science (de 1994 a junio 2007). Asimismo,...

Objective To determine the attitude to therapy of primary care staff in view of the lack of reduction in blood pressure. To describe the most commonly used antihypertensives. Design Descriptive, longitudinal, retrospective study during the year 2001. Setting Primary care, Spain. Participants We analysed 990 hypertensive patients from 12 health c...

To establish what proportion of hypertensive patients being treated in the primary care health centres of Spain have diminished renal function, and to ascertain their level of blood pressure (BP) control. Descriptive, cross-sectional study, based on an external audit of clinical charts. Primary care health centres in 14 autonomous regions. A total...

Objective To establish what proportion of hypertensive patients being treated in the primary care health centres of Spain have diminished renal function, and to ascertain their level of blood pressure (BP) control. Design Descriptive, cross-sectional study, based on an external audit of clinical charts. Setting Primary care health centres in 14 a...

Objetivo Evaluar los efectos de la administración de una combinación de perindopril, un inhibidor de la enzima de conversión de la angiotensina (IECA) e indapamida, un diurético tiazídico, en los episodios vasculares graves que presentan los pacientes diabéticos, con independencia de los valores iniciales de la presiónarterial (PA) o del uso de otr...

Introduction This study aims to analyze if the origin of the population influences the incidence of high blood pressure (HBP) and in its screening according to the recommendations of the Preventive Activities and Health Promotion program. Material and methods Retrospective cohort study in the scope of Primary Care. The population seen and assigned...

Objectives To evaluate the degree of control of blood pressure (BP) in the autochthonous and immigrant populations and to find the variables linked to good control. Design Cross-sectional, observational study. Setting Urban primary care team, Spain. Participants All patients with hypertension seen between 1/1/2000 and 1/7/2005 and whose origin w...

To evaluate the degree of control of blood pressure (BP) in the autochthonous and immigrant populations and to find the variables linked to good control. Cross-sectional, observational study. Urban primary care team, Spain. All patients with hypertension seen between 1/1/2000 and 1/7/2005 and whose origin was known: 1.063 patients in all, 931 autoc...

Objetivos Conocer qué variables clínicas se asociaban con una mayor probabilidad de diagnosticar hipertensión de bata blanca (HBB) empleando la automedida de la presión arterial domiciliaria (AMPAd). Los datos para la realización del estudio se TABLA 1.. Características clínicas de los pacientes diagnosticados de hipertensión de bata blanca o hiper...

Objetivo Conocer el efecto sobre el estado de forma de mujeres de un programa de ejercicio físico que supone el 50 y el 100% de la actividad recomendada por los National Institutes of Health (NIH) Consensus Development Panel. Diseño Estudio aleatorizado controlado. Emplazamiento Centros sanitarios universitarios de Dallas (Estados Unidos). Pobla...

Introducción Algunos estudios previos habían intentado demostrar que los antagonistas de los receptores de la angiotensina II (ARA-II) reducían el riesgo de aparición de eventos cardiovasculares (ECV), pero no habían incluido a la población asiática. Objetivo Determinar si añadir valsartán a la terapia habitual de pacientes hipertensos o con enfer...

El efecto de las distintas clases de hipotensores en la incidencia de diabetes mellitus (DM) es controvertido, porque los metaanálisis tradicionales cuentan con la dificultad de la heterogeneidad de los ensayos clínicos (EC), y dada la ausencia de estudios que comparen los inhibidores de la enzima conversiva de la angiotensina (IECA) con los antago...

g , R. Marín-Iranzo h , C. Megía i , L. Rodríguez-Mañas

To describe the variations in the diagnosis performance of home blood pressure self-monitoring (hBPSM) with different methods for mean calculation, in order to diagnose white-coat hypertension (WCH). Multi-centre, descriptive, and comparative study to assess the diagnosis performance of a test method. Four primary health care centres. A total of 15...

Objective To describe the variations in the diagnosis performance of home blood pressure self-monitoring (hBPSM) with different methods for mean calculation, in order to diagnose white-coat hypertension (WCH). Design Multi-centre, descriptive, and comparative study to assess the diagnosis performance of a test method. Setting Four primary health...

To determine the diagnostic performance of home blood pressure self-monitoring in white-coat hypertension using a 3-day reading program. One hundred and ninety nontreated patients recently diagnosed with mild-moderate hypertension, selected consecutively at four primary healthcare centers in the city of Barcelona, were included. Each patient underw...

Objectives: To Evaluate the frequency of cardiovascular events of a hypertensive patients cohort, in relation to the presence of left ventricular hypertrophy diagnosticated by echocardiogram, in Primary Care Attention.

To assess the effectiveness of blood pressure self-monitoring at home in front of 24-h blood pressure ambulatory measurement in isolated clinical hypertension diagnosis. Comparative study of repeated measurements of self-monitoring home BP and 24-h ambulatory BP measurement in a hypertensive patients sample. SETTING AND SUBJECTS TO STUDY: Mild-mode...

Objetivo Revisar la eficacia de varios fármacos antihipertensivos en la reducción de la presión arterial (PA) y la morbimortalidad en pacientes hipertensos de raza negra. Fuentes de datos y selección de estudios Se revisaron las siguientes bases de datos: Medline, Embase, Lilacs, African Index Medicus y Cochrane desde su inicio hasta 2004, y PubMe...

Objective To evaluate the effectiveness of selfmeasurement of blood pressure (SMBP) in controlling hypertension. Design Randomized, controlled, pragmatic, open study. The unit of randomization was the basic health care unit (BCU), consisting of 1 physician and 1 nurse. All BCUs were randomized to the control group (usual clinical practice, n=94) o...

Objective To assess the efectiveness of blood pressure self-monitoring at home in front of 24-h blood pressure ambulatory measurement in isolated clinical hypertension diagnosis. Design Comparative study of repeated measurements of self-monitoring home BP and 24-h ambulatory BP measurement in a hypertensive pacients sample. Setting and subjects t...

Objetivo Comparar el efecto del amlodipino o el enalapril, respecto al placebo,en la aparición de episodios cardiovasculares (ECV) en pacientes conenfermedad coronaria (EC) y valores no elevados de presión arterial (PA). Diseño Estudio aleatorizado, doble ciego, multicéntrico. Seguimiento medio: 24 meses. Emplazamiento Cien centros especializados...

Objetivo Evaluar los efectos de los inhibidores de la enzima de conversion de la angiotensina (IECA) y delos antagonistas de los receptores de la angiotensina- II (ARA-II) en las complicaciones renales y la mortalidad total en pacientes con nefropatía diabética. Fuentes de datos y selección de estudios Se revisaron las siguientes bases de datos: M...

To evaluate the effectiveness of self-measurement of blood pressure (SMBP) in controlling hypertension. Randomized, controlled, pragmatic, open study. The unit of randomization was the basic health care unit (BCU), consisting of 1 physician and 1 nurse. All BCUs were randomized to the control group (usual clinical practice, n=94) or to the interven...

To evaluate the changes in the diagnosis and follow-up of hypertension, and in the evaluation of cardiovascular risk, in a population served by primary care centers in Catalonia (northeastern Spain). Management was evaluated with indicators published in the Guidelines for Hypertension for Primary Care (Guía de Hipertensión Arterial para la Atención...

Introduction To determine the degree of blood pressure (BP) control in a sample of the hypertensive and diabetic reformed primary care center (PCC) attended population in Catalonia. To compare results with those from the year 1996. Material and methods Cross-sectional, multicenter, before-after study. Random sample of 306 clinical histories of hyp...

To assess whether the frequency of cardiovascular risk factors and end-organ damage is greater among non-dipper hypertensive patients. Descriptive cross-sectional study involving 290 hypertensive patients at an urban primary care center. All patients underwent 24-hour ambulatory blood pressure measurement (ABPM). The following variables were inclu...

To evaluate high blood pressure (HBP) control and cardiovascular risk factors of individuals aged 65 and older receiving medical attention in Catalonia. To compare the accuracy of control with results obtained five years ago. Descriptive cross-sectional study. Primary care. External auditing of 990 medical histories of hypertensive patients receiv...

Background and objective Our objective was to evaluate, through the health related quality oflife (HRQoL) questionnaire MINICHAL, the influence of socio-demographic, clinical and therapeuticvariables on health related quality of life of hypertensive patients. Patients and method An observational, prospective and multi-center study was carried out...

Objetivo Analizar los resultados obtenidos en individuos hipertensos de edad avanzada tratados con inhibidores de la enzima conversiva de la angiotensina (IECA), comparado con los obtenidos con diuréticos Diseño Estudio prospectivo, aleatorio y abierto, con valoración ciega de los puntos finales. Seguimiento medio de 4,1 años Emplazamiento 1.594...

Our objective was to evaluate, through the health related quality of life (HRQoL) questionnaire MINICHAL, the influence of socio-demographic, clinical and therapeutic variables on health related quality of life of hypertensive patients. An observational, prospective and multi-center study was carried out in hypertensive patients who were either sta...

Am J Hypertens (2003) 16, 55A–55A; doi:10.1016/S0895-7061(03)00212-7 P-46: Is diabetes and hypertension care improving in catalonia? Mar Piqueras1, Antoni Dalfó1, Mencia Benitez1, Susana Pérez1, Gustavo Losada1 and M.Antonia Vila11EAP Gòtic, ICS, Barcelona, Catalonia, Spain; EAP Gòtic, ICS, Barcelona, Catalonia, Spain; EAP Gòtic, ICS, Barcelona, C...

Aims: To evaluate hypertension diagnosis and follow-up in a population attending primary care centres in Catalonia (Spain) being audited in the course of DISEHTAC study in 1996 in relationship to the performance of a minila intervention.

The finding that low health-related quality of life (HRQoL) can be a risk factor for future cardiovascular events in patients with hypertension emphasizes the need for disease-specific HRQoL assessment tools in this population. This study evaluated the feasibility and psychometric properties of the short form of the Spanish Hypertension Quality of...

Objective Study the relation between quality of life (QoL) and various clinical, therapeutic and sociodemographic variables in treated hypertensive patients. Material and methods A prospective study was carried out in 92 primary care centres in Spain. A total of 269 hypertensive patients were selected and 106 healthy normotensive individuals were i...