Control of hypertension in patients at high risk of cardiovascular disease.
BACKGROUND
Hypertension is a major cardiovascular risk factor, but knowledge about the real magnitude of the problem and its determinants is lacking.


OBJECTIVE
To assess control of hypertension and evaluate medical resource use, in patients at high risk of cardiovascular disease.


METHODS
Multicentric cross-sectional study.


METHODS
We collected data for 2205 adult patients from 36 centres, representative of all regions of Spain. Patients had attended out-patient clinics from July 2002 to August 2003, had an absolute cardiovascular risk > or =20% at 10 years (according to the Framingham guidelines), and had a diagnosis of hypertension. Pregnant and terminally ill patients were excluded.


RESULTS
Hypertension was inadequately controlled in 1384 patients (62.8%). LDL cholesterol was higher in patients with uncontrolled hypertension (median 130.2 vs. 120.0 mg/dl, p < 0.001). Haemoglobin A(1c) in diabetic patients was also greater in those with uncontrolled hypertension (median 7.10% vs. 6.90%, p = 0.010). Uncontrolled hypertension was associated with the following variables, in descending strength of association: higher LDL cholesterol, taking antihypertensive medication, living in non-metropolitan areas, and higher body mass index.


CONCLUSIONS
Hypertension is poorly controlled in most patients with a high risk of cardiovascular disease. Uncontrolled hypertension is frequently associated with poor control of other risk factors.
Roca
B
B
Hospital General, Castellón, University of Valencia, Madrid, Spain. brocav@meditex.es
Suárez
C
C
Ceballos
A
A
Varela
J M
JM
Nonell
F
F
Montes
J
J
Sobrino
J
J
de la Peña
A
A
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013030:Spain
D000959:Antihypertensive Agents