title: Cardiovascular risk factors are not treated to target in hypertensive patients in primary care.
abstract: The awareness and control of cardiovascular risk factors other than blood pressure in hypertensive subjects in primary healthcare is not well described. This was examined by data extraction from electronic records from a random sample (115 women and 85 men) corresponding to two-thirds of all hypertensive subjects within a well-defined geographic area in Sweden. Target blood pressure (<140/90 mmHg, <130/80 mmHg if diabetes or kidney disease) was achieved in 27%, and lipid levels (total and LDL-cholesterol <5 and <3.0 mmol/l, respectively) in 42%. Beta-blockers were the most common antihypertensive drug class; 39% were given lipid lowering drugs. The distributions of antihypertensive and lipid lowering drugs were similar across gender and age groups. Patient records often contained information on body mass index, lipid levels, diabetes, left ventricular hypertrophy, microalbuminuria, and smoking habits (reported in 89%, 89%, 73%, 67%, 62% and 61%), but rarely on physical exercise, family history, concurrent cardiovascular disease or alcohol habits (reported in 47%, 46%, 39% and 18%). In conclusion, hypertensive patients in primary healthcare do not have well controlled blood pressure and lipids. The awareness and documentation of several cardiovascular risk factors is low. Improvement in risk assessment and treatment may have substantial effects on prognosis.
authors.affiliation: Stocksund Primary Health Care Centre, Stocksund, Sweden.
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Nieburg
authors.forename: Thomas
authors.initials: T
authors.lastname: Kahan
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000209:etiology*; D002319:Cardiovascular System / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy; D015444:Exercise; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000188:drug therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000150:complications / Q000188:drug therapy; D008055:Lipids / Q000097:blood / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents; D008055:Lipids