title: Risk factors associated with uncontrolled hypertension: findings from the baseline CARMEN survey in Cienfuegos, Cuba.
abstract: OBJECTIVE
  Identifying methods to improve pharmacologic control of elevated blood pressure remains the most urgent challenge in clinical research on hypertension. The probability of having inadequate control varies widely in the population and better understanding of the factors responsible could help to focus treatment strategies.
  
  
  METHODS
  A population-based community survey of 1475 persons aged 25-74 years, in Cienfuegos, Cuba, was used to identify these factors in a low-resource setting.
  
  
  RESULTS
  While half of women with hypertension were controlled, only one-third of men were receiving successful treatment. Gender differences were not seen, however, among those currently taking medications. The largest burden of hypertension in absolute terms was concentrated in the age range 45-64, emphasizing the heavy burden of uncontrolled high blood pressure that falls on middle-aged men. Race-ethnicity was not a determinant of treatment and control status, nor was inability to obtain medication.
  
  
  CONCLUSIONS
  These findings largely confirm the pattern observed in industrialized countries and demonstrate the near-universal challenge confronting primary-care systems in physician-based control of cardiovascular risk factors.
authors.affiliation: Hospital Universitario Dr Gustavo Aldereguía Lima, Cienfuegos, Cuba.
authors.forename: Pedro
authors.initials: P
authors.lastname: Ordúñez
authors.forename: Alberto
authors.initials: A
authors.lastname: Barceló
authors.forename: José L
authors.initials: JL
authors.lastname: Bernal
authors.forename: Alfredo
authors.initials: A
authors.lastname: Espinosa
authors.forename: Luis C
authors.initials: LC
authors.lastname: Silva
authors.forename: Richard S
authors.initials: RS
authors.lastname: Cooper
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003430:Cross-Sectional Studies; D003462:Cuba / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017211:Treatment Failure; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D000959:Antihypertensive Agents