Clinical outcome of hypertension management.
OBJECTIVE
This study aimed to investigate the association between inadequately controlled hypertension, medication use pattern and the incidence of cardiovascular events (CVEs) over 5 years. The cost of hospitalisation associated with inadequately controlled hypertension was estimated.


METHODS
This was a retrospective observational study of patients who were diagnosed with hypertension with at least one blood pressure reading recorded at baseline (year 2000), reviewed from 2001-2005. Primary endpoints were the extent, duration and prevalence of blood pressure deviation from treatment goals. Secondary endpoints were incidence of CVEs and the number of days of hospitalisation associated with inadequately controlled hypertension.


RESULTS
In total, the medical records of 210 patients were reviewed. Statistically significant positive associations were found between inadequately controlled systolic blood pressure with the incidence of CVEs (p=0.018) and increased cardiovascular drugs (p<0.001), non-cardiovascular drugs (p=0.019) and total drug usage (p<0.001). Similar observations were observed between inadequately controlled diastolic blood pressure and increased cardiovascular (p<0.05) and total (p=0.007) drug usage. Patients with uncontrolled blood pressure at all times during the study period were associated with a higher incidence of CVEs (p=0.026). The mean cost of hospitalisation due to CVEs was estimated to be HK$42,584.0 +/- 36,670.0 (US$1 = HK$7.8) and it accounted for 3.3% of the total healthcare expenditure during 2005.


CONCLUSIONS
Inadequately controlled blood pressure is positively associated with an increased incidence of CVEs and polypharmacy in Hong Kong Chinese hypertensive patients.
Lee
Vivian Wy
VW
School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong. vivianlee@cuhk.edu.hk
Chan
Tony Hw
TH
Ko
Tina Tl
TT
Lee
Kenneth Kc
KK
Tomlinson
Brian
B
D000367:Age Factors; D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015897:Comorbidity; D004363:Drug Utilization; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome
D002317:Cardiovascular Agents