The EDAPA Project (Education of self-measurement of blood pressure) in Grottaglie

Abstract

AIM OF THE STUDY The EDAPA Project (Education of self-measurement of blood pressure) was conceived to train hypertensive patients in self blood pressure monitoring (SBPM) and to survey their feedback, including patient’ assessment, by recording their related cardiovascular diseases (CVD risks factors) and lifestyle habits. METHODS The project was conducted during the year 2006. Initially we met Grottaglie’s citizens and illustrated to participants the importance of SBPM at home in the overall management of hypertension, that might lead to a better control of BP and cardiovascular outcomes. After explaining the correct technique for SBPM, we distributed semiautomatic devices (OMRON M6) and asked the participants to fill in the Hypertension Questionnaire Form and to record their own blood pressure values in a diary. RESULTS Among almost 3,000 citizens interviewed, 370 (198 M, 172 F; mean age: 60 years) agreed to take part in our study. They were hypertensive for almost 10 years, but waited 3 years before beginning therapy. They measured BP 4 times a month and, in the same sitting, 66% of them carried out only 1 measurement, 29% of them 2 measurements and only 2.5% carried out 3 measurements. Taking as reference BP value of 135/85 mmHg, we registered 28% of the population as normotensive and the remaining 72% as hypertensive. Among the hypertensives, 30% showed a good control, 55% showed a bad one and the remaining 15% was not aware of being hypertensive. Adding non-treated hypertensives to those treated but not controlled, we noticed that 70% of the participants was not properly controlled. Regarding risk factors, almost 64% showed hypercholesterolemia; 18% were smokers; 35% of males and 28% of females showed hyperglicemia and 63% of the latter had a waist line > 88 cm; 32% used to consume alcohol (46% males and 15% females); 26% had a metabolic syndrome; 13% was affected by vascular brain injuries, 30% by peripheral artheriopaty, 35% had heart diseases, 10% was nephropatic and 13% diabetic. CONCLUSIONS By this project we evidenced that, with simple devices and low costs, it is possible to make people understand the importance of self-measurement for a more practical management of the illness, for the follow-up of the BP values and to verify the efficiency of the treatment. A more active and direct role of hypertensive patients in their own medical care could reasonably bring a reduction of expenses in long-term management of the disease, a reduction of inappropriate shifts of therapy and, as seen, an increased reliability of the self-measured pressure values.