[Study of the stroke and coronary risks in hypertensive patients over 54 years of age in the primary care practice].
OBJECTIVE
Quantification of stroke risk is not always performed in hypertensive patients in Primary Care.


METHODS
This was an epidemiological study in hypertensive patients aged 55 years and older attending primary care centres in Spain. The D'Agostino Stroke Risk Scale, using data from the Framingham Study, was used for assessment of stroke risk.


RESULTS
We analysed 4,945 patients (mean age, 66.8 years; 50.9% females). Mean blood pressure (BP) values were 145/86 mmHg in men and 143.7/84.7 mmHg in women (p < 0.001). The majority of patients (80.5%) showed high BP values that were above the values recommended in the guidelines, despite most of them (89.6%) receiving pharmacological antihypertensive treatment. 41% of patients were diabetics. The 10-year global risk of stroke was 22.5%, and was higher in men (28.6% vs. 16.8%; P < 0.001). The risk of stroke increased with age, being more marked in women. Several risk factors showed a statistically significant association with the risk of stroke. From higher to lower significance, these risk factors were: age, left ventricular hypertrophy (LVH), cardiovascular disease, systolic BP, auricular fibrillation, diabetes, cigarette smoking, control of BP, gender, and antihypertensive treatment. The 10-year coronary risk was higher in men (24.2% vs. 16.0%; p < 0.001) and was significantly related to the 10-year risk of stroke (r = 0.626).


CONCLUSIONS
The risk of stroke in the Spanish hypertensive population is high, and is significantly higher in men, although it shows a larger age-related increase in women. Linear regression analysis showed a moderate, but statistically significant, correlation between coronary risk and risk of stroke. Apart from all the variables included in the Framingham Stroke Risk Model, gender, control of BP, and antihypertensive treatment accounted significantly and independently as calculated risk factors for incidence of stroke.
Roca-Cusachs Coll
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A
Unida de HTA, Hospital de la Santa Creu i Sant Pau, Barcelona, España. aroca@santpau.es
Muñoz Lloret
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A
de Castellar
R
R
Garrido Costa
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C
D000367:Age Factors; D000368:Aged; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D011320:Primary Health Care; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology*