Recomendaciones latinoamericanas para el manejo de la hipertensión arterial en adultos (RELAHTA 2)

  • Rodrigo Sabio Sociedad Argentina de Medicina
  • Pascual Valdez Sociedad Argentina de Medicina
  • Yazmin Abuabara Turbay Asociación Colombiana de Medicina Interna
  • Rodrigo Eduardo Andrade Belgeri Sociedad de Medicina Interna del Uruguay
  • Gustavo Adolfo Arbo Oze de Morvil Sociedad Paraguaya de Medicina Interna
  • Claudia Arias Sociedad de Medicina Interna de la República Dominicana
  • Luis Alberto Cámera Sociedad Argentina de Medicina
  • Virgil Carballo Zárate Asociación Colombiana de Medicina Interna
  • Hugo Celauro Falcón Sociedad Paraguaya de Medicina Interna
  • Ramez Constantino Chahin Sociedad Venezolana de Medicina Interna
  • Jorge Contreras Monchez Asociación de Medicina Interna de El Salvador
  • Miguel Ángel Contreras Zambrano Sociedad Venezolana de Medicina Interna
  • Coral Cristaldo Sociedad Boliviana de Medicina Interna
  • Erik Dávila Sociedad Venezolana de Medicina Interna
  • Ernesto De los Santos Godoy Sociedad de Medicina Interna del Uruguay
  • Sergio Díaz Asociación Dominicana de Médicos Internistas
  • Lorenzo Díaz Salazar Sociedad Hondureña de Medicina Interna
  • Maritza Durán Castillo Sociedad Venezolana de Medicina Interna
  • Katia Ninoska Echegaray Castro Sociedad Peruana de Medicina Interna
  • Fredy Antonio Figueroa Guilamo Sociedad de Medicina Interna de la República Dominicana
  • José Galarza Nuñez Asociación Dominicana de Médicos Internistas
  • Jorge Óscar García Méndez Colegio de Medicina Interna de México
  • Helí Hernández Ayazo Asociación Colombiana de Medicina Interna
  • Sara Hernández Araque Sociedad de Medicina Interna del Uruguay
  • Cristina López Sánchez Sociedad Venezolana de Medicina Interna
  • Felipe Melgar Cuellar Sociedad Cruceña de Medicina Interna
  • Rubén Montúfar Asociación de Medicina Interna de El Salvador
  • José Ortellado Maidana Sociedad Paraguaya de Medicina Interna
  • Gabriela Ormaechea Sociedad de Medicina Interna del Uruguay
  • Mario Patiño Torres Sociedad Venezolana de Medicina Interna
  • Eduardo Penny Montenegro Sociedad Peruana de Medicina Interna
  • Verónica Pérez Papadopulos Sociedad de Medicina Interna del Uruguay
  • Homero Luis Puello Galarcio Asociación Colombiana de Medicina Interna
  • Williams Rojas Cifuentes Sociedad de Medicina Interna del Uruguay
  • Selva Romero Sociedad de Medicina Interna del Uruguay
  • Samuel Salazar Rodríguez Sociedad Peruana de Medicina Interna
  • Virginia Alejandra Salazar Matos Sociedad Venezolana de Medicina Interna
  • Mariflor Vera Sociedad Venezolana de Medicina Interna
  • Pablo Vergara Hanson Sociedad Boliviana de Medicina Interna
  • Hugo Zelechower Sociedad Argentina de Medicina
Palabras clave: Hipertensión, guía, morbilidad, mortalidad, antihipertensivos - farmacología, terapia combinada, inercia, estilos de vida, prevención primaria, prevención secundaria, prevención terciaria, prevención cuaternaria.

Resumen

Se presenta la segunda parte de las recomendaciones latinoamericanas para el manejo de la Hipertensión Arterial (HTA) en adultos. En una primera fase se han descripto los aspectos más relevantes de la epidemiología, aspectos fisiopatológicos, cómo hacer diagnóstico, pautas terapéuticas, urgencias y emergencias hipertensivas, poblaciones especiales, hipertensión refractaria y la aplicación de las guías en la vida real. En esta segunda parte, se emiten recomendaciones respondiendo a preguntas específicas para prevención primaria, secundaria, terciaria y cuaternaria. En general pocas recomendaciones al respecto del manejo de la hipertensión arterial surgen desde la clínica médica/ medicina interna, a pesar de dos situaciones: la mayoría de los pacientes con hipertensión arterial son evaluados y manejados por los clínicos, y la clínica médica es la especialidad que permite la mirada holística e integrada de los problemas de salud del adulto, permitiendo agregar el enfoque biográfico al biológico, comprender e interpretar no solo el problema de salud sino sus causas y consecuencias (que muchas veces suelen corresponder a diferentes parénquimas, lo cual en el modelo fragmentado haría transitar al paciente por distintas especialidades). El bajo porcentaje de pacientes hipertensos controlados obliga a todos los profesionales involucrados en el manejo de los mismos a  optimizar recursos y detectar problemas que se asocien a un control deficitario como la sub utilización del tratamiento farmacológico, baja tasa de pacientes tratados con estrategia combinada (la mayoría de los pacientes actualmente recibe monoterapia),  falta de prescripción adecuada de los cambios en el estilo de vida,  baja adherencia terapéutica e inercia clínica. En la presente publicación se presentan recomendaciones efectuadas por especialistas en clínica médica / medicina interna para el manejo de la hipertensión arterial en adultos, respondiendo preguntas de prevención primaria, secundaria, terciaria, y cuaternaria.

Citas

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Publicado
2019-03-01
Sección
ARTÍCULOS DE REVISIÓN