Revista Portuguesa de Hipertensão e Risco Cardiovascular

THE ROLE OF HEALTH LITERACY IN THE MEDICATION ADHERENCE OF PATIENTS DIAGNOSED WITH HYPERTENSION: AN EVIDENCE-BASED REVIEW

Fri, 11 Apr 2025 00:00:00 -0700

Introduction: Hypertension (HTN) is the most prevalent cardiovascular disease in the world. Only one in five people with HTN has the disease under control. Medication adherence plays a crucial role in controlling HTN. In a study conducted in 2008, it was found that half of patients discontinued antihypertensive medication within a year.

Purpose: Understand the role of health literacy in medication adherence in adults with HTN.

Methodology: In this review, we used the MeSH: “health literacy” AND “hypertension” AND “medication adherence”. We searched for systematic reviews (SR), randomized clinical trials, meta-analyses and articles published between 2013 and 2023, in Portuguese, English and Spanish, in the Cochrane Library and PubMed databases. We applied the PICO methodology - Population: adults (≥18 years old) with HTN; Intervention: health literacy; Comparison: non-intervention;

Outcome: medication adherence; The level of evidence and strength of recommendations were assigned based on the SORT (Strenght of Recommendation Taxonomy) classification.

Results: From the initial search, we selected 108 articles, of which 82 were excluded after reading the title or abstract. After fully reading the articles, 9 met the inclusion criteria: two SR and 7 observational studies.

Discussion/Conclusions: Of the 9 studies analyzed, three did not have statistically significant results (n=807), while 6 demonstrated a statistically significant connection (n=4094).

The main limitation identified was the use of different scales to assess medication adherence and health literacy. Furthermore, the population evaluated in most studies belongs to minorities and, to date, no studies have been carried out at an European level. According to the review carried out, the evidence points to a positive impact of health literacy on medication adherence (Strength of recommendation B).

Editorial

Luís Bronze — Fri, 11 Apr 2025 00:00:00 -0700

PROFILES AND IMPACT OF HYPERTENSIVE DISORDERS IN PREGNANCY: A 10-YEAR RETROSPECTIVE STUDY

Juliana Carneiro, Joana Coutinho, Catarina Santos — Fri, 11 Apr 2025 00:00:00 -0700

Introduction: Hypertensive disorders are one of the main causes of pregnancy-related morbidity and mortality worldwide, and they can be grouped into 4 categories: chronic hypertension, gestational hypertension, pre-eclampsia/eclampsia or pre-eclampsia superimposed on chronic hypertension.

Objetive: This study aimed to characterize pregnant women with chronic or gestational hypertension followed in arterial hypertension nephrology consultation and evaluate gestational outcomes in women.

Materials and methods: This is a descriptive, retrospective study, analyzing the clinical processes of pregnant women, with chronic or gestational hypertension, followed in the arterial hypertension consultation, at a level III hospital, from January 2013 to January 2023. In data analysis, analytical and descriptive statistics were performed using Microsoft Office Excel 365 Software and Statistical Package for the Social Sciences (version 28).

Results, discussion and conclusion: This study, which included 30 pregnant women with hypertensive disorders, unlike some other studies, found no significant association between social status and hypertensive disorders during pregnancy. A correlation was observed between gestational hypertension and mild preterm labour, highlighting the need for close monitoring. Despite the limitations, such as the small sample size and the cross-sectional nature of the study, the importance of balancing blood pressure control with fetal risks is highlighted, emphasising the postpartum period as critical in preventing cardiovascular complications.

ENABLEMENT AND QUALITY OF LIFE OF HYPERTENSIVE PATIENTS LIVING ON MADEIRA ISLAND

Sara Góis Freitas, Marta Dora Freitas Ornelas, José Augusto Rodrigues Simões — Fri, 11 Apr 2025 00:00:00 -0700

Introduction: Arterial Hypertension (AHT) is the most common chronic disease and the leading cause of death in Portugal. Adopting a healthy lifestyle is relevant to preventing hypertension and delaying the need to start pharmacological therapy. Enablement understood as the acquisition of information by patients about their pathology during a medical appointment, has benefits in reducing hypertension.

Objectives: To assess the enablement of hypertensive patients followed up in the ACES (Group of Health Centers) of Madeira Island; to assess the quality of life (QoL) of hypertensive patients; to understand whether patients with greater enablement have better BP control and a better QoL, and to compare the enablement assessed by hypertensive patients with the enablement perceived by the general practitioners who follow them.

Material and Methods: Cross-sectional and observational study of a convenience sample of hypertensive patients, using the CapHTA questionnaire for patients, which assesses enablement in hypertension, the EQ-5D scale, which analyses QoL and questions that allow the sociodemographic characterization of the sample. The CapHTA questionnaire for doctors was administered to the respective primary care physicians. Descriptive and inferential parametric and non-parametric statistics were performed.

Results: A sample of 80 hypertensive patients was studied, predominantly female (57.5%) and with primary school education (65.8%). The worst results verified were found on questions 5 and 6 of the CapHTA questionnaire. Statistically significant differences were found in training according to level of education, with the groups with lower levels of education having a higher proportion of correct answers. There was no statistically significant correlation between blood pressure (BP) control and empowerment, nor between BP control and QoL.

Discussion: This study’s results suggest some deficits in the enablement of hypertensive patients, which must be corrected if patients are to achieve better BP control and better QoL.

Conclusion: Doctors’ perceptions of their patients’ knowledge of AHT coincide with what patients know about their condition. Further studies should be carried out on the island of Madeira with larger samples to reinforce the conclusions drawn.

RESUMOS DO 19º CONGRESSO PORTUGUÊS DE HIPERTENSÃO E RISCO CARDIOVASCULAR GLOBAL

José Carvalho — Fri, 11 Apr 2025 00:00:00 -0700