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National Survey on Excellence Centers and Reference Centers for Hypertension Diagnosis and Treatment: Geographical Distribution, Medical Facilities and Diagnostic Opportunities

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An Erratum to this article was published on 24 June 2014

Abstract

Introduction

Blood pressure (BP) control is poorly achieved in Western Countries, including Italy. Several interventions have been proposed at national and local level to improve BP control rate.

Aim

This survey of the Italian Society of Hypertension (SIIA) is aimed at analysing the number and the distribution of reference centers and excellence centers for the diagnosis and treatment of arterial hypertension (hypertension centers) in Italy.

Methods

In October 2011, a specifically designed survey questionnaire was developed by SIIA National Committee, both to evaluate geographical distribution of the reference hypertensive population and to assess general requirements (days of activity, number of active physicians, medical facilities, diagnostic opportunities, use of electronic support), deemed necessary to identify an outpatient clinic as hypertension center in Italy. This questionnaire was locally distributed by regional coordinators of the Society and all collected data were centrally analysed by two independent study coordinators.

Results

From October 2011 to September 2012, 89 centers with clinical expertise in the diagnosis and treatment of hypertension provided data on their own activity. Among these, 45 (50.5 %) centers are located in the North, 20 (22.5 %) in the Center and 24 (27.0 %) in the South of Italy. Approximately 50 % of the hypertensive outpatients who are referred from general practitioners to hypertension centers are living in the province and about one third in the region. More than half of the centers is active for 3–5 days per week, and approximately 40 % of the centers have 3–5 active physicians. Beyond outpatient visits for hypertension, these centers are able to organize day hospital (25 %), day service (29 %), or hospital admission (29 %) for advanced diagnostic evaluation or therapeutic interventions. All centers collect data from clinic and 24-hour ambulatory BP measurements, and almost all (95 %) centers are able to perform a standard 12-lead electrocardiogram. In addition, the majority of the centers are able to perform advanced diagnostic examinations, including echocardiography (74 %) or carotid Doppler ultrasound (71 %) analysis. Finally, 78 % of the centers use an electronic case report form, specifically designed for the clinical management of hypertensive patients.

Conclusions

Although with some limitations related to the study methodology applied for data collection, the survey illustrates a quite unbalanced distribution of the hypertension centers, the majority of which are located in the North of Italy, with a medium-high standard of quality of care. This analysis may provide useful elements for a rational and effective use of existing resources, in order to improve BP control in our Country.

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Acknowledgments

The Italian version of the document has been published in Italian language on the Ipertensione & Prevenzione Cardiovascolare journal.

Endorsement

This work has been endorsed by the Italian Society of Hypertension (SIIA).

Conflict of interest disclosure

There are no conflict of interest and no financial disclosure to disclose.

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome “Sapienza”, Sant’Andrea Hospital, Via di Grottarossa 1035-39, 00189, Rome, Italy

    Giuliano Tocci & Massimo Volpe

  2. Clinical Medicine, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy

    Maria Lorenza Muiesan

  3. Division of Internal Medicine, University of Bologna, Bologna, Italy

    Ettore Ambrosioni & Claudio Borghi

  4. Department of Internal Medicine and Specialties, University of Palermo, Palermo, Italy

    Santina Cottone

  5. Department of Clinical Medicine and Prevention, University of Milano Bicocca, Centro Ricerche Cliniche, Istituto Auxologico Italiano IRCCS, Milano, Italy

    Cesare Cuspidi & Giuseppe Mancia

  6. Department of Clinical and Experimental Medicine, University of Napoli Federico II, Napoli, Italy

    Nicola De Luca

  7. Department of Medicine, Clinica Medica 3, University of Padova, Padova, Italy

    Francesco Fallo

  8. Division of Internal Medicine 1, Hypertension and Cardiovascular Prevention Unit, School of Internal Medicine, University of L’Aquila, San Salvatore Hospital, L’Aquila, Italy

    Claudio Ferri

  9. Division of Internal Medicine, Hypertension Unit, San Giuseppe Hospital, Milano, Italy

    Alberto Morganti

  10. Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy

    Maria Lorenza Muiesan

  11. Division of Internal Medicine, University of Marche, Ancona, Italy

    Riccardo Sarzani

  12. Clinica Medica, Department of Clinical and Experimental Medicine, University of Udine, Udine, Italy

    Leonardo Sechi

  13. Department of Internal Medicine, University of Pisa, Pisa, Italy

    Agostino Virdis

Authors
  1. Giuliano Tocci
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  2. Nicola De Luca
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  3. Riccardo Sarzani
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  4. Ettore Ambrosioni
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  5. Claudio Borghi
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  6. Santina Cottone
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  7. Cesare Cuspidi
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  8. Francesco Fallo
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  9. Claudio Ferri
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  10. Alberto Morganti
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  11. Maria Lorenza Muiesan
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  12. Leonardo Sechi
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  13. Agostino Virdis
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  14. Giuseppe Mancia
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  15. Massimo Volpe
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Corresponding author

Correspondence to Giuliano Tocci.

Additional information

2013 Survey of the Italian Society of Hypertension - Società Italiana dell’Ipertensione Arteriosa (SIIA).

Electronic supplementary material

Below is the link to the electronic supplementary material.

Appendix A (online available). Survey questionnaire for data collection.

Appendix B (online available). List of excellence centers and reference centers for the diagnosis and treatment of hypertension in Italy. ESH Excellence Center are reported in bold characters.

Supplementary material 1 (DOC 52 kb)

Supplementary material 2 (DOC 130 kb)

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Tocci, G., De Luca, N., Sarzani, R. et al. National Survey on Excellence Centers and Reference Centers for Hypertension Diagnosis and Treatment: Geographical Distribution, Medical Facilities and Diagnostic Opportunities. High Blood Press Cardiovasc Prev 21, 29–36 (2014). https://doi.org/10.1007/s40292-013-0034-z

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