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Revista Virtual de la Sociedad Paraguaya de Medicina Interna

versão On-line ISSN 2312-3893

Resumo

SABIO, Rodrigo et al. Latin American recommendations for the management of hypertension in adults (RELAHTA 2). Rev. virtual Soc. Parag. Med. Int. [online]. 2019, vol.6, n.1, pp.86-123.  Epub 01-Mar-2019. ISSN 2312-3893.  https://doi.org/10.18004/rvspmi/2312-3893/2019.06(01)86-123.

The second part of the Latin American recommendations for the management of Arterial Hypertension (HTA) in adults is presented. In a first phase, the most relevant aspects of epidemiology, physiopathological aspects, how to diagnose, therapeutic guidelines, hypertension emergencies, special populations, refractory hypertension and the application of guides in real life have been described. In this second part, recommendations are issued answering specific questions for primary, secondary, tertiary and quaternary prevention. In general, few recommendations regarding the management of arterial hypertension arise from the medical clinic / internal medicine, despite two situations: the majority of patients with hypertension are evaluated and managed by the clinicians, and the medical clinic is the specialty that allows the holistic and integrated look of the health problems in adults, allowing to add the biographical approach to the biological, to understand and interpret not only the health problem but its causes and consequences (which often correspond to different parenchyma, which in the fragmented model would make the patient move through different specialties). The low percentage of controlled hypertensive patients forces all the professionals involved in the management of them to optimize resources and detect problems that are associated with a deficit control such as the under utilization of pharmacological treatment, low rate of patients treated with combined strategy (the most patients currently receive monotherapy), lack of adequate prescription of changes in lifestyle, low therapeutic adherence and clinical inertia. This publication presents recommendations made by specialists in medical clinic/internal medicine for the management of hypertension in adults, answering primary, secondary, tertiary and quaternary prevention questions.

Palavras-chave : Hypertension; guidelines; recommendations; cardiovascular morbidity; cardiovascular mortality; antihypertensive drugs; adherence; monotherapy; combination therapy; clinical inertia; lifestyles; primary prevention; secondary prevention; tertiary prevention; quaternary prevention..

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