ABC | Volume 115, Nº2, August 2020

Original Article Blood Pressure Control and Associated Factors in a Real-World Team-Based Care Center Thiago Veiga Jardim, 1, 2 Ana Luiza Lima Souza, 1,2 Weimar Kunz Sebba Barroso, 1, 2 Paulo Cesar B. Veiga Jardim 1, 2 Universidade Federal de Goiás - Programa de Pós-Graduação em Ciências da Saúde, 1 Goiânia, GO - Brazil Universidade Federal de Goiás - Liga de Hipertensão Arterial, 2 Goiânia, GO - Brazil Mailing Address: Thiago de Souza Veiga Jardim • Universidade Federal de Goiás - Programa de Pós-Graduação em Ciências da Saúde - Primeira Avenida S/N Setor Leste Universitário, Goiânia, GO – Brazil E-mail: thiagoloirin@hotmail.com Manuscript received March 01, 2019, revised manuscript May 23, 2019, accepted July 17, 2019 DOI: https://doi.org/10.36660/abc.20180384 Abstract Background: Although team-based care is recommended for patients with hypertension, results of this intervention in a real-world setting are missing in the literature. Objective: To report the results of a real-world long-term team-based care for hypertensive patients we conducted this study. Methods: Data of hypertensive patients attending a multidisciplinary treatment center located in the Midwest region of Brazil in June 2017 with at least two follow-up visits were retrospectively assessed. Anthropometric, blood pressure (BP), follow-up time, pharmacological treatment, diabetes and lifestyle data were collected from the last visit to the service. BP values < 140 x 90 mmHg in non-diabetics and < 130 x 80 mmHg in diabetics were considered controlled. A logistic regression model was built to identify variables independently associated to BP control. Significance level adopted p < 0.05. Results: A total of 1,548 patients were included, with a mean follow-up time of 7.6 ± 7.1 years. Most patients were female (73.6%; n=1,139) with a mean age of 61.8 ±12.8 years. BP control rates in all the sample, and in non-diabetics and diabetics were 68%, 79%, and 37.9%, respectively. Diabetes was inversely associated with BP control (OR 0.16; 95%CI 0.12-0.20; p<0.001) while age ≥ 60 years (OR 1.48; 95%CI 1.15-1.91; p=0.003) and female sex (OR 1.38; 95%CI 1.05-1.82; p=0.020) were directly associated. Conclusions: A BP control rate around 70% was found in patients attending a multidisciplinary team care center for hypertension. Focus on patients with diabetes, younger than 60 years and males should be given to further improve these results. (Arq Bras Cardiol. 2020; 115(2):174-181) Keywords: Hypertension; Blood Pressure/prevention and control; Exercise; Treatment Adherence and Compliance; Sedentarism; Obesity; Life Style. cardiovascular events and death in various clinical conditions involving different BP levels, cardiovascular risk profiles, and comorbidities. 6,7 Despite that, uncontrolled HTN remains a widely prevalent situation worldwide. 8 Among the strategies aimed to improve BP control, team- based interventions have shown to be highly promising. 9,10 They consist of organizational, patient-centered, multifaceted interventions, led by multidisciplinary teams, aimed at improving the quality of HTB care. HTN team-based care includes patients, patient’s primary care providers, and other professionals, such as cardiologists, nurses, pharmacists, physician assistants, dietitians, social workers, community health workers, and others. These workers complement each other by providing process support and sharing responsibilities. 1 Although team-based care is recommended for patients with HTN by most guidelines, 1,2,11,12 results of this intervention in a real-world setting are missing in the literature. We conducted this study aiming to report the results of a long- term multidisciplinary treatment intervention for patients with HTN, specifically assessing BP control rates and associated factors. Introduction Hypertension (HTN) is defined as elevated blood pressure (BP) levels based on an average of ≥ two careful readings obtained on ≥ two occasions, or current use of BP-lowering medications. 1,2 Although there is some debate on which thresholds should be used to define HTN, there is no doubt about the burden of HTN as a cardiovascular risk factor and a major cause of disability and death. 3-5 Elevated BP is the most important treatable risk factor for stroke, atrial fibrillation and heart failure. 5 Reductions in BP are effective to prevent target organ damage, 174