[Impact of the presence of cardiovascular disease on blood pressure and lipid control in the hypertense population attended in primary care].
OBJECTIVE
To determine the impact of cardiovascular disease (CVD) (heart failure, ischaemic heart disease, stroke, renal insufficiency, and peripheral arterial disease) on blood pressure (BP) and LDL-cholesterol (LDL-C) control in hypertense patients.


METHODS
We analysed the subset of patients with CVD from those included in the PRESCOT study (a cross-sectional study of hypertense patients attended in primary care).


METHODS
A total of 2000 primary care physicians participated in the study.


METHODS
In an analysis of 12 954 patients (50.1% males; aged 62.1 [10.7]), good BP control was defined as <140/90 mm Hg (<130/80 mm Hg for diabetics) and good LDL-C control, according to the ATP-III stipulations for every risk group.


RESULTS
Overall, 3294 (25.43%) patients had established CVD (mean age, 66.0 [10.2] years; 56.3% males). Of these, 82.2% had dyslipidaemia and 45.6% were diabetics (vs 72.3% and 23.9%, respectively, in non-CVD group; P< .0001). Patients with CVD were treated with more anti-hypertensives (55.7% vs 30.4% were on é2 drugs; P< .001) and more lipid-lowering drugs (67.6% vs 55.4%, P< .001) than patients without CVD. BP was controlled in 25.3% of patients with CVD versus 26.7% (P=.095); and LDL-C in 13.3% versus 40.2% (P< .001). Only 7.0% of patients with CVD were well controlled for both parameters versus 18.7% of those without CVD (P< .001). The main predictive factors of poor BP control were Diabetes (OR, 1.20; 95% CI, 1.10-1.30), sedentary lifestyle (OR, 1.19; 95% CI, 1.11-1.29) and female gender (OR, 1.12; 95% CI, 1.02-1.23), among others; whilst the main factors for poor LDL-C control were a family history of CVD (OR, 1.34; 95% CI, 1.24-1.46), sedentary lifestyle (OR, 1.28; 95% CI, 1.18-1.39), and diabetes (OR, 1.15; 95% CI, 1.06-1.26).


CONCLUSIONS
BP and LDL-C control in the hypertense population with CVD is very poor. In fact, only 7% of these patients have both parameters well controlled.
Barrios Alonso
Vivencio
V
Instituto de Enfermedades del Corazón, Hospital Ramón y Cajal, Madrid, España. vbarriosa@meditex.es
Escobar Cervantes
Carlos
C
Calderón Montero
Alberto
A
Llisterri Caro
José Luis
JL
Echarri Carrillo
Rocío
R
Matalí
Arantxa
A
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000150:complications; D016009:Chi-Square Distribution; D008078:Cholesterol, LDL / Q000097:blood; D005194:Family Practice; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy*; D006973:Hypertension / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011320:Primary Health Care; D013030:Spain
D000959:Antihypertensive Agents; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents