title: Prevalence and treatment of hypertensive patients with multiple concomitant cardiovascular risk factors in The Netherlands and Italy.
abstract: The Anglo-Scandinavian Cardiac Outcomes Trial-Lipid-Lowering Arm (ASCOT-LLA) trial demonstrated the benefits of combined antihypertensive/lipid-lowering treatment over antihypertensive treatment alone in hypertensive patients with > or =3 additional cardiovascular (CV) risk factors. We assessed the prevalence and treatment of patients with hypertension and > or =3 additional CV risk factors in The Netherlands and Italy in a retrospective cohort study using the Integrated Primary Care Information (IPCI) database in The Netherlands and the Health Search/Thales Database (HSD) in Italy. Patients aged > or =16 years, with 1 year of valid database history, diagnosed and/or treated for hypertension (>140/90 mmHg) during 2000-2002 were included in the study. The IPCI and HSD populations consisted of approximately 175000 and approximately 325000 patients, respectively. The prevalence of hypertension increased from 20.3 to 22.3% in the IPCI, and from 19.0 to 21.8% in the HSD during 2000-2002. The prevalence of > or =3 concomitant risk factors among hypertensive patients increased from 31.2 and 31.1% in 2000 to 34.2 and 39.3% in 2002 in the IPCI and HSD, respectively. From 2000 to 2002, among hypertensive patients with > or =3 CV risk factors and no prior symptomatic CV disease (CVD) approximately 54-57% in the IPCI and 80-83% in the HSD received antihypertensive treatment. In these patients, the use of combined antihypertensive and lipid-lowering treatment increased from 14.2 to 17.6% in the IPCI and from 15.5 to 17.4% in the HSD from 2000 to 2002. This study shows that primary prevention of CVD in hypertensive patients in The Netherlands and Italy could be improved.
authors.affiliation: Department of Medical Informatics and Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. m.sturkenboom@erasmusmc.nl
authors.forename: M C J M
authors.initials: MC
authors.lastname: Sturkenboom
authors.forename: J P
authors.initials: JP
authors.lastname: Dieleman
authors.forename: G
authors.initials: G
authors.lastname: Picelli
authors.forename: G
authors.initials: G
authors.lastname: Mazzaglia
authors.forename: E
authors.initials: E
authors.lastname: Mozaffari
authors.forename: A
authors.initials: A
authors.lastname: Filippi
authors.forename: C
authors.initials: C
authors.lastname: Cricelli
authors.forename: J
authors.initials: J
authors.lastname: van der Lei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents