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Factores de riesgo de la hipertensión arterial. Centro de Salud San Simón Distrito 02D01, Zona 5, Bolívar, 2023

Risk factors for high bl= ood pressure.  

 


= 1=

Génesis Alejandra Castro Naranjo

https://orcid.org/0009-0008-3717-4000

 

Médico Rural de centro de salud San Simón tipo A MSP

gacastronczs5@gmail.co m

= 2=

Gladys Magdalena Naranjo Chávez

 

https://orcid.org/0000-0003-1786-9979

 

Universidad Estatal de Bolívar (UEB), Ecuador, Guaranda

gnaranjo@ue= b.edu.ec

3

Ana Gabriela Aillon Albán                                       https://orcid= .org/0009-0005-0984-8280

Médico Rural del Centro de Salud San Lorenzo Tipo A MSP

ana1999a= illon@gmail.com   

 

 

 

 

&n= bsp;

 

Artículo de Investigación Científica y Tecnológica=

Enviado: 17/12/2023

Revisado: 18/01/2024

Aceptado: 01/02/2024

Publicado:21/02/2024

DOI: https://d= oi.org/10.33262/concienciadigital.v7i1.1.2947

 

 

 

Cítese:

 

 <= /o:p>

Castro Naran= jo, G. A., Naranjo Chávez, G. M., & Aillon Albán, A. G. (2024). Factores de riesgo de la hipertensión arterial. Centro de Salud San Simón Distrito 02= D01, Zona 5, Bolívar, 2023. ConcienciaDigital, 7(1.1), 151-165. https://d= oi.org/10.33262/concienciadigital.v7i1.1.2947

 

 

 

CONCIENCIA DIGITAL, es u= na revista multidisciplinar, trimestral, que se publicará en soporte electrónico tiene como misión contribuir a la   formació= n de profesionales competentes con visión humanística y crítica que sean capac= es de exponer sus resultados investigativos y científicos en la misma medida= que se promueva mediante su intervención cambios positivos en la sociedad.&nb= sp;https://concienciadigital.org  

La revista es editada por la Editorial Ciencia Digital (Editorial de prestigio registrada en la Cámara Ecuatoriana de Libro con No de Afiliación 663) www.celibro.org= .ec

 = ;

 

 

Esta revis= ta está protegida bajo una licencia Creative Commons AttributionNonCommercialNoDerivatives 4.0 International. Copia de la licencia: http://creative= commons.org/licenses/by-nc-nd/4.0/

 

Palabras claves: hipertensión arteria= l, factor de riesgo, incidencia, prevalencia.

 

 

Resumen <= o:p>

Introducció= n: la hipertensió= n arteri= al constituye uno de los principales problemas que afecta la salud p<= span style=3D'mso-bidi-font-size:12.0pt;line-height:115%;font-family:"Calibri"= ,sans-serif; mso-ascii-font-family:"Times New Roman";mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman";mso-bidi-theme-font:minor-bidi; color:black;mso-themecolor:text1'>ública; debido a la presencia de factore= s de riesgo, cada dí= a avanza= en el mundo y cada vez es mayor el nú= mero de personas que resultan afectadas en su calidad de vida. Objetivo: caracterizar los factores de riesgo de la hipertens= ión arterial en pacientes del Centro de S= alud de San Simó= n en el = año 2023. Metodología= : se rea= lizó un estudio observacional, descriptivo = de corte transversal. El universo y muestra del estudio estuvo constituido p= or 16 pacientes con Diagnostico de hipertensió= n arteri= al del á= rea de S= an Simón al ser = un nú= mero óptimo pa= ra el estudio y que acuden al control frecuente de su patología. Las variables utilizadas fueron: eda= d, sexo, ocupació= n, facto= res de riesgo de la hipertensió= n arteri= al (antecedentes patoló= gicos personales, antecedentes patoló= gicos familiares, sedentarismo, obesidad, há= bitos alimenticios, há= bitos t<= /span>óxicos como alcoholismo, tabaquismo y consumo de cafeí= na. Resultados: el 75% de los pacie= ntes se encontraban en la edad de má= s de 51 = años. Se encontró predominio del sexo femenino ocupando = este el 75%. El 31 % son jubilados. El 56% de los pacientes presentan como fac= tor de riesgo los APF, predominando el sexo femenino con 12 pacientes, seguido por los antecedentes patoló= gicos personales. Conclusiones: la elevada predisposició= n genética, la edad y el padecimiento de comorbilidades asociadas y factores de riesgo modificables en la poblaci<= /span>ón estudiada aumenta el riesgo de padecer hipertensió= n arteri= al. Área de estudio general:  Medicina. Á= rea de estudio especí= fica:  Cardiologí= a. Ti= po de estudio: original.

=  

 

Keywords:

arter= ial hypertension, risk factor, incidence, prevalence.

 

Abstract

Introduction: Arterial hypertension is one of the main problems affecting public health; due to the presence of risk factors, it is advancing every day in= the world and the number of people who are affected in their quality of life = is increasing. Objective: To ch= aracterize the risk factors for hypertension in patients at the San Simón Health Center in 2023. = Methodology: An observational, descriptive cross-sectional study was conducted. The universe and sample of the study consisted of 16 patients diagnosed with arterial hypertension from the San Simón area, as it is an optimal number for the study and who attend to frequent control of their pathology. The variables u= sed were age, sex, occupation, risk factors for hypertension (personal pathological history, family pathological history, sedentary lifestyle, obesity, eating habits, toxic habits such as alcoholism, smoking and caffeine consumption= . Results: 75% of the patients we= re over 51 years of age. A predominance of women was found, occupying 75%. 3= 1% are retirees. APF was a risk factor for 56% of patients, with 12 patients predominating females, followed by personal pathological history. Conclusions: The high genetic predisposition, age and the suffering of associated comorbidities and modifiable risk factors in the studied population increase the risk of hypertension. General Area of Study:  Medicine. Specific area of study:  Cardiology. Type of study: original.

 

 

 

Introducción<= /span>

La hipertensión arterial (HTA) es una enfermedad no comunicable, generalmente asintomática que afecta a un gran porcentaje de la población adulta y genera daños a órganos nobles como corazón cerebro y riñ= ón. Según  Munir et al. (2018), la HTA como enfermedad= no transmisible, será una de las causas principales de discapacidad funcional = en las próximas dos décadas. Por tal motivo, la HTA es un problema de salud pública debido a su magnitud, los riesgos, la dificultad en la gestión, los altos costos médicos y sociales y las graves complicaciones cardiovasculare= s y renales .

Las Enfermedades Crónicas no Transmisibles (ECNT) constituyen uno de los problemas de salud más importantes y complejos en los países desarrollados y en muchos que están en vías de desarrollo. Dentro de= las enfermedades no transmisibles, la hipertensión arterial (HTA) constituye un factor de gran importancia, por su alta prevalencia y su acción sobre órgan= os vitales, lo que hace que sea considerada como trazadora dentro de las no transmisibles constituyendo por sí misma una enfermedad, como también un fa= ctor de riesgo para otras enfermedades.

Según Nicolás Robles (2008) “la presión arterial (PA)= es un parámetro cambiante que sigue la presencia de ritmos orgánicos intrínsec= os, factores ambientales, físicos y emocionales que actúan sobre los individuos= ”. La presión arterial sistólica normal corresponde a menos de 120 mmHg y la p= resión arterial diastólica normal corresponde a menos de 80 mmHg. Si el promedio d= e la presión arterial es igual o mayor 140 mmHg (sistólica) o igual o mayor a 90 mmHg (diastólica) es considerada HTA (Munir et al., 2018). Este valor es un límite inferior aceptado, de manera generalizada, como el punto de partida = del cual se incrementa, de manera significativa, la morbilidad y mortalidad rel= acionadas con esta enfermedad (Cabrera et al., 2002).

En el siglo III D.C., el médico indio Juan Miguel de = Mora (1990), menciona por primera vez en sus textos los síntomas que podrían ser coherentes con la hipertensión. Personalidades como el Emperador Amarillo en China, el médico Cornelio Celso e Hipócrates estudiaban la forma de tratarl= a (Buzzi, 2016). Su comprensión moderna comienza en los años 1578-1657 por el médico William Harvey en su libro De motu cordis.  En 1733 Stephen Hales se destacó por ser= el primero en realizar la toma de la presión en la historia.=

 En los últim= os años, la prevalencia de HTA ha afectado mayoritariamente a los países desarrollados, en donde el tratamiento y el control inadecuado aumenta el riesgo de generar afecciones que pueden ser letales para el ser humano  (Salazar, 2016). Según la Organización Panamericana de la Salud [OPS] & Organización Mundial de la Salud [OMS] (2013), se considera a u= na persona como hipertensa cuando presenta una cifra mayor a 140/90 mmHg. Por ello, a nivel mundial existe un alto incremento de la HTA, en el que uno de= los grupos más vulnerables son los adultos mayores debido al proceso de envejecimiento, en el cual puede existir un “incremento en la rigidez de las arterias y el remodelado vascular”.

Los investigadores calculan que la hipertensión es la causa por la que mueren anualmente nueve millones de personas Para el año 2= 050 la quinta parte de la población mundial será mayor de 80 años. Uno de cada = tres adultos en América Latina sufre hipertensión arterial definida como la elev= ación sostenida de la presión arterial sistólica, diastólica o las dos que afecta= a la mayor parte de la población adulta (Ministerio de Salud Pública [MSP], 2014).

La hipertensión arterial aumenta con el envejecimient= o, ante las crecientes tasas de obesidad y el mayor envejecimiento de la población,= se prevé que en 2025 la hipertensión afecte a 1.500 millones de personas. En la actualidad, en torno a un 54% de los accidentes cerebrovasculares y el 47% = de las cardiopatías isquémicas a escala global son atribuibles a valores altos= de presión arterial (Rivero et al., 2018).

La Organización Panamericana de la Salud [OPS] & Organización Mundial de la Salud [OMS] (2013), informa q= ue la máxima prevalencia de hipertensión se registra en la Región de África, c= on un 46 % y la más baja se observa en la Región de las Américas, con un 35 %.=

 CITATION Fre14 \l 12298  (MSP, 2014).

 CITATION Fre14 \l 12298  (MSP, 2014).  Según la zona de planificación, la zona= 5 (Santa Elena, Guayas, Bolívar, Los Ríos y Galápagos, tiene mayor prevalenci= a de hipertensión arterial en el Ecuador. En San Simón que constituye una de las ocho parroquias del cantón Guaranda, las personas diagnosticadas con hipertensión arterial lo constituyen unas 180, las cuales acuden periódicam= ente a su control a la unidad de salud.

Metodología =

Se realizó un estudio observacional, descriptivo de c= orte transversal en el período comprendido entre los meses de septiembre a novie= mbre del 2023. La población del estudio estuvo constituida por 16 pacientes con hipertensión arterial atendidos en el centro de salud de San Simón del dist= rito 2D01, Zona 5 Bolívar.

Para la elaboración de esta investigación se utilizar= on varios métodos que permitieron el estudio, recopilación y procesamiento de = toda la información para resolver la problemática planteada, tales como:  Método empírico: observación, entrevist= as y análisis de documentos. Para la recopilación de los datos se utilizaron la = guía observación y la guía de entrevista, mediante los cuales se confeccionaron = las Historias Clínicas Individuales y las Historias de Salud Familiar que nos brindaron la información requerida. Se tuvieron en cuenta las variables a estudiar que se correspondían con los objetivos de la investigación.

Las variables utilizadas fueron: edad, sexo, ocupació= n, factores de riesgo de la hipertensión arterial (antecedentes patológicos personales, antecedentes patológicos familiares, sedentarismo, obesidad, hábitos alimenticios, hábitos tóxicos), utilizamos las historias clínicas i= ndividuales y las historias de salud familiar  = con parámetros éticos: a todas las personas que conformaron la muestra de estud= io se les realizó la entrevista para llenar las historias de Salud Familiar co= n el consentimiento previo y se les informó que los datos obtenidos serían utilizados para un trabajo investigativo, siendo afirmativa su participació= n. No se declararon conflictos de intereses.

Procesamiento y análisis de la informació= n, análisis de resultados

A continuación, se expondrán los resultado= s y discusiones pertinentes de la información recopilada durante el estudio.  Durante la investigación se estudiaron = a 16 pacientes, con diagnóstico de hipertensión arterial todos cumplieron con los criterios de inclusión, con su capacidad para realizar la entrevista médica= .

Tabla 1

Edad de los pacientes con hipertensión arterial atendidos en el Centro de Salud de San Simón=

Categoría

 Frecuencia (f)

Porcentaje (%)

15-20 años

0

0

21 a 30 años

0

0

31 a 40 años

0

0

41-50 años

1

6

De 51 a mas

15

94

Total

16

100

Nota: Historia de salud individual y familiar

De los 16 pacientes con hipertens= ión arterial que se registran en este estudio. Se encontró que el 94% (15) tiene más de 51años; 1paciente con 41 a 50 años. Predominando la edad adulta.

Tabla 2

Genero de los pacientes con hipertensión arterial atendidos en el Centro de Salud de San Simón=

Categoría

Frecuencia (f)

Porcentaje (%)

Hombre

4

25

Mujer

12

75

Total

16

100

Nota: Historia de salud individual y familiar<= o:p>

De los 16 pacientes registrados en este trabajo, el 75% que tienen hipertensión arterial son mujeres.

Tabla 3

Ocupación de los pacientes con hipertensión arterial atendidos en el Centro de Salud de San Simón=

Categoría

 Frecuencia (f)

Porcentaje (%)

Estudiante

0

0

Agricultor

4

25

Empleado

3

19

Jubilado

5

31

Ninguno

4

25

Total

16

100

Nota: Historia de salud individual y familiar<= o:p>

Del 100 % de los pacientes de este estudio el 31% son Jubilados, seguidos del 25%, de pacientes que son agricultores, el 19% son empelados y hay 4 pacientes que no tienen ocupación.  

Tabla 4

Escolar= idad de los pacientes con hipertensión arterial atendidos en el Centro de Salud = de San Simón

Categoría

 Frecuencia (f)

Porcentaje (%)

Primaria

9

56

Secundaria

4

25

Tercer Nivel

3

19

Ninguno

0

0

Total

16

100

Nota: Historia de salud individual y familiar<= o:p>

Del 100% de los pacientes de este estudio el 56% tienen instrucción primaria, mientras que el 44%, tienen instrucción secundaria y de tercer nivel.

Tabla 5

Antecedentes patológicos personales de los= pacientes atendidos con hipertensión arterial en el Centro de Salud de San Simón=

Categoría

 Frecuencia (f)

Porcentaje (%)

Enfermedades Renales<= /p>

2

13

Diabetes mellitus

2

13

Otras enfermedades

5

31

No tienen enfermedades

7

43

Total

16

100

Nota: Historia de salud individual y familiar. Otras enfermedades: colelitiasis, fibrosis pulmonar, policitemia, cáncer de mama, hipotiroidismo, hipertrofia prostática.

Del = 100% de los pacientes del estudio se encontró que el 13% de los pacientes mostra= ron antecedentes personales de enfermedades renales; un 13%, mostraron diabetes mellitus, 31% tienen otras comorbilidades añadidas y hay un 43% que no tien= en ningún antecedente patológico de importancia.

Tabla 6

Antecedentes patológicos familiares presencia de familiares con hipertensión arterial

Categoría

 Frecuencia (f)

Porcentaje (%)

Madre

2

12

Padre

4

25

Hermanos

2

13

Abuelos

1

6

Desconoce

7

44

Total

16

100

Nota: Historia de salud individual y familiar

De los 16 pacientes del estudio se encontró que el 25%, tienen un padre portador de la enfermedad, el 13% tien= en hermano con la genetica,12%, tienen una madre con la genética de la enferme= dad, el 44% restante desconoce si algún familiar cercano tiene hipertensión arterial.

Tabla 7

Distribución de l= os factores de riesgos de los pacientes atendidos con hipertensión arterial en el Centro de Salud de San Sim= ón


 

Categoría

 Frecuencia (f)

Porcentaje (%)

Edad más de 51 a años

15

75

Edad de 41-50 anos

1

25

Sedentarismo

13

81

Realiza actividades físicas

3

19

Obesidad

9

56

Peso Normal

7

43

Hábitos alimenticios inadecuados

13

81

Hábitos alimenticios adecuados

3

19

Hábitos tóxicos

6

37

Nota: Historia de salud individual y familiar<= o:p>

Del 100% de los pacientes del est= udio se encontró que el (75 %), corresponde a la edad del adulto mayor, el sedentarismo con el 81 %, la obesidad con el (56 %), los hábitos alimenticios inadecuados el (81%), y hábitos tóxicos (37%), son los factores de riesgo con elevada prevalencia.

Tabla 8

Relació= n de consanguinidad de los pacientes con hipertensión arterial atendidos en Cent= ro de Salud de San Simón

Categoría

 Frecuencia (f)

Porcentaje (%)

Madre

2

13

Padre

3

19

Hermanos

2

12

Abuelos

1

6

Desconoce

8

50

Total

16

100

Nota: Historia de salud individual y familiar<= o:p>

De los 16 pacientes del estudio se encontró que el 19%, tienen al padre con factor genético de la enfermedad, = el 13%, tienen madre con factor genético 12%, tienen un tío con factor genético predisponente de la enfermedad, el 50% restante desconoce si sus familiares tienen factor predisponente para la enfermedad,6% corresponde al factor genético heredado de los abuelos.

Discusión

La hipertensión arterial se ha convertido en un problema alarmante para la humanidad por la elevada incide= ncia y prevalencia que presentan. La HTA es, dentro de las enfermedades crónicas, una de las más frecuentes con importantes repercusiones en el orden persona= l, económico y sanitario

El impacto negativo de la HTA crece a nivel global, debido al incremento del envejecimiento demográfico, al crecimiento poblacional y a una mayor exposición de la población a factores= de riesgo .

En cuanto a las características sociodemográficas de = la población estudiada, el sexo  femen= ino predominó con 75%, al igual que en el estudio de Llisterri et al. (2008), cuya población de estudio fueron los pacientes hipertensos atendidos en el municipio Marianao (Cuba) con un 63,20%, y estu= dios de  Mena-Díaz et al. (2018), cuya población fueron pacientes hipertensos usuarios del programa de salud cardiovascular de un centro de salud familiar (Chile) con un 75,9%, afirmán= dose que el sexo tiene influencia para la existencia de la enfermedad.

Respecto al nivel de instrucción el 56 % de los pacie= ntes solo tienen educación primaria contrario a los estudios de  Ojeda= (2019),    el 56,7% tenían educación secundaria,= 52,2% tenían estudios superiores (Alférez, 2019), y el 42,60% son analfabetos .Se= gún la ocupación en nuestro estudio predominó el 31% jubilado y el 25 % es Agricultor, los resultados de los otros estudios fueron: el 35,7% tenían negocios, y el 36,7% son funcionarios  (Ojeda= , 2019), se evidencia la discrepancia en cuanto a ocupación se refie= re.

Por la predisposición genética individual, comorbilidades asociadas y la influencia de factores modificabl= es. Según Baglietto-Hernández et al. (2020), el componente genético juega un pa= pel muy importante en la enfermedad. La investigación muestra como factor más predominante los antecedentes patológicos familiares de HTA,

Un estudio realizado por Morejón et = al. (2020), describe que presentar este antecedente aumenta 6 veces más el ries= go de padecer HTA. Las patologías asociadas resultó ser el segundo factor de riesgo más importante, con presencia en el 44% de los pacientes de la muest= ra de estudio con diabetes mellitus, y otras comorbilidades asociadas.

Otros factores de riesgo presentes s= on sedentarismo, obesidad, hábitos alimenticios inadecuados y hábitos tóxicos = Al analizar el estilo de vida que practicaban los pacientes con hipertensión arterial estudiados, se evidencia en forma global que  los pacientes  poseen un  81% con sedentari= smo, 56% con obesidad,37% con hábitos tóxicos,  regular  estilo de vida, y 1= 9% poseen un buen estilo de vida, resultados que difieren con el estudio de Corne= jo et al. (2023), quienes encontraron en su estudio que el estilo de vida mayormente es medio o no saludable con un 42,5% y 57,5% saludable. El estudio de  Cornejo et al. (2023),  coincide con el estudio al reportar en sus resultados que el estilo de vida en relación con la práctic= a de autocuidado es regular, deficiente o inadecuado en un 80% y adecuado 20%. S= in embargo, nuestros resultados difieren con el estudio de Mena-Díaz<= /span> et al. (2018), quien encontró en sus resultados que el estilo de vi= da que realizaban los hipertensos era mayormente bueno en un 70%. =

Por tal motivo, es importante hacer énfasis en la implementación de medidas de promoción y prevención en salud = en cuanto a cambios en estilos de vida como mejorar la alimentación, evitar el sedentarismo, evitar consumo de alcohol y/o tabaco los cuales son factores predisponentes para desarrollar enfermedades cardiovasculares.

El envejecimiento poblacional y el aumento de estilos de vida no saludables demandan la realización de accione= s de promoción y prevención de la HTA, caracterizada por su elevada incidencia y prevalencia cada año a nivel mundial. La presencia de factores de riesgo de= la HTA en la población se hace más evidente, su influencia en el aceleramiento= de la aparición de la enfermedad ha sido comprobado científicamente. Es moment= o de enfocarse en acciones para disminuir la gran cantidad de pacientes, a parti= r de la correcta dispensarización de la población y a partir de ahí encaminar acciones individuales y colectivas.

Conclusiones

·         A través de la revisión bibliográfica se ha evidenciado que la hipertensión arterial es un trastorno hereditario que se caracteriza por se= r es un problema de salud pública debido a su magnitud, los riesgos, la dificultad en la gestión, los altos costos médicos y sociales y las graves complicaciones cardiovasculares y renales lo que hace que sea considerada c= omo trazadora dentro de las no transmisibles constituyendo por sí misma una enfermedad, como también un factor de riesgo para otras enfermedades.

·         Luego de realizar este estudio se observó que, de los 16 pacientes en esta Unidad de Salud, cada uno de estos tuvieron algún familiar cercano con hipertensión arterial.

·         Los antecedentes personales en los pacientes hipertensos de presentar enfermedades renales, diabetes mellitus, y otras comorbilidades, son considerados como un factor que influye en los antecedentes.

·          Los Factores de riesgo modificables como el sedentarismo, la obesidad, hábitos alimenticios inadecuados, hábitos tóxicos frecuentes incrementan el riesgo de hipertensi= ón arterial.

·         Los pacientes actualmente atendidos pueden presentar mayor riesgo de complicaciones tanto por su enfermedad como por las comorbilidades que presentan asociadas a la edad.

·      =    La elevada predisposición genética, el padecimiento de comorbilidades asociadas y factores de riesgo modificables en la población estudiada aumenta el riesgo de padecer hipertensión arterial, una enfermedad de elevada prevalencia e incidencia e= n el mundo y en nuestro país.=

Conflicto de intereses<= /o:p>

Los autores declaran no te= ner conflicto de interés

Referencias Bibliográficas

Alférez Condori, Jhanira Betshabét. (2019). Factores que influyen en la adherencia al tratamiento antihipertensivo en pacientes del programa de hipertensión arterial de la= red asistencial de Essalud – Tacna [Tesis de pregrado, Universidad Privada de Tacna, Tacna, Perú]. https://repositorio.upt.edu.pe/bitstream/handle/20.500.12969/683/AlferezC= ondori-Jhanira.pdf?sequence=3D1&isAllowed=3Dy<= /span>

Baglietto= -Hernández, J. M., Mateos-Bear, A., Nava-Sánchez, J. P., Rodríguez-García, P., & Rodríguez-Weber, F. (2020). Nivel de conocimiento en hipertensión arteria= l en pacientes con esta enfermedad de la Ciudad de México. Revista Medicina Interna México, 36(1):1-14. https://doi.org/10.24245/mim. v36i1.2844

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Salazar Cáceres, P. M., Rotta Rotta, A., Otiniano Costa, F. (2016). Hipertensión arterial en el adulto mayor. Revista Médica Herediana, 2016(27): 60-66. www.scielo.org.pe/pdf/rmh/v27n1/a10v27n1.pdf

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El artículo que se publica es de exclusiva responsabilidad de los autores y no necesariamente reflejan el pensamiento de la Revista Conciencia Digital.

 


 

 

 

El artículo queda en propiedad de la revista y, por tanto, su publicación parc= ial y/o total en otro medio tiene que ser autorizado por el director de la Revista Conciencia Digital.<= /o:p>

 

 

 

 

 


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ISSN: 2600-5859

Vol. 7 No. 1.1, pp. 151 – 165, febrero 2024

 

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