Cardiovascular risk profile and blood pressure control in Italian hypertensive patients under specialist care.
BACKGROUND
Information on the association between high hypertension and metabolic risk factors in Italy is limited. Furthermore, data on the rate of blood pressure control in the Italian hypertensive population are restricted to some Italian regions only, and refer usually to surveys performed, in most instances, several years ago.


METHODS
In the present study, a total of 4059 essential hypertensive patients were examined consecutively from March to June 2000 by 450 cardiovascular specialists (cardiologists, internists and diabetologists) operating throughout the Italian territory. Analysable data were obtained in 3812 patients.


RESULTS
Blood pressure control by treatment (< 140/90 mmHg) was infrequent (11.9%), this being particularly the case for systolic as compared to diastolic blood pressure (15.1 versus 33.7%). Hypertension was the only risk factor in only 13.7% of the patients, the association with diabetes, hypercholesterolaemia or obesity characterizing the remaining cases. About 60% of the patients fell into the high or very high cardiovascular risk category of the World Health Organization/International Society of Hypertension (WHO/ISH) Guidelines. Compared to low or moderate cardiovascular risk, multiple antihypertensive drug treatment was more frequently used in individuals at high or very high risk. These conditions were frequently underdiagnosed by physicians.


CONCLUSIONS
Thus, in Italy, hypertension continues to be a poorly controlled condition. Despite being a Mediterranean country, the occurrence of hypertension is commonly associated with metabolic risk factors and often with a high or very high cardiovascular risk profile. This is not properly identified by specialist physicians.
Mancia
Giuseppe
G
Istituto Auxologico Italiano IRCCS, Milano. giuseppe.mancia@unimb.it
Volpe
Roberto
R
Boros
Stefano
S
Ilardi
Maura
M
Giannattasio
Cristina
C
D000368:Aged; D000553:Ambulatory Care; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology*; D008076:Cholesterol, HDL / Q000097:blood; D003971:Diastole / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology / Q000503:physiopathology; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D013038:Specialization; D013599:Systole / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D015415:Biomarkers; D008076:Cholesterol, HDL