[Blood pressure control in hypertensive patients with left ventricular hypertrophy. The VIIDA Study].
OBJECTIVE
The aims were to determine the effectiveness of blood pressure (BP) control in hypertensive patients with left ventricular hypertrophy (LVH), as detected by ECG, and to identify the variables associated with poor control, particularly in diabetics.


METHODS
The study included hypertensive patients with ECG evidence of LVH who attended cardiology outpatient clinics between April 2003 and November 2004. Patient characteristics and clinical variables were recorded on admission to the study.


RESULTS
Of the 16,123 patients included, 4037 (25.04%) had LVH at presentation. Some 58.1% of these latter patients had a history of cardiovascular disease. Only 8.1% of diabetic patients had BP values below 130/80 mmHg, whereas 22.4% of nondiabetic patients were well-controlled. Multivariate analysis showed that the only independent predictors of poor BP control were diabetes (odds ratio [OR] 3.62, 95% confidence interval [CI] 2.7-4.7), female sex (OR 1.18, 95% CI 1.02-1.33), increased voltage recording in lead V5 (OR 1.027 per mm, 95% CI 1.01-1.03), and body mass index (OR 1.03, 95% CI 1.00-1.05), whereas a history of cardiovascular disease was associated with good BP control (OR 0.57, 95% CI 0.48-0.70).


CONCLUSIONS
The prevalence of LVH, as identified by ECG, was high in hypertensive patients attending cardiology outpatient clinics, and comorbid conditions were common. Control of BP was suboptimal, particularly in diabetic patients, fewer than 10% of whom were well-controlled. Finally, BP control in patients with LVH was influenced by sex, body mass index, and a history of cardiovascular disease.
Bertomeu
Vicente
V
Servicio de Cardiología, Hospital San Juan de Alicante, Alicante, España.
Fácila
Lorenzo
L
González-Juanatey
José R
JR
Cea-Calvo
Luis
L
Aznar
Joaquín
J
Mazón
Pilar
P
Bertomeu González
Vicente
V
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003925:Diabetic Angiopathies / Q000188:drug therapy; D003971:Diastole; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D017678:Sex Distribution; D013030:Spain; D013599:Systole
D000959:Antihypertensive Agents