title: Achievement of cardiometabolic goals in aware hypertensive patients in Spain: a nationwide population-based study.
abstract: Despite the importance of achieving cardiometabolic goals beyond blood pressure, in the health of hypertensives, no comprehensive assessment of these characteristics has been performed in whole countries. We studied in 2008-2010 a total of 11 957 individuals representative of the Spanish population aged≥18 years. Information on cardiometabolic characteristics was collected at the participants' homes, through structured questionnaires, physical examination, and fasting blood samples. A total of 3983 individuals (33.3%) had hypertension (≥140/90 mm Hg or current antihypertensive drug treatment), 59.4% were aware of their condition, 78.8% treated among those aware, and 48.5% controlled among those aware and treated (22.7% of all hypertensives). Of the aware hypertensives, 13.8% had a body mass index<25 kg/m2, 38.6% consumed <2.4 g/d of sodium, 19.3% were diabetic with 61% attaining goal hemoglobin A1c<6.5%, whereas 42.3% had hypercholesterolemia, with 38.1% reaching goal low-density lipoprotein<115 mg/dL. Only 30.7% of overweight patients received a prescription of specific method for weight loss, 17.4% of daily smokers were offered a smoking cessation strategy, and 15.8% of older patients were given a flu shot. Aware and unaware hypertensives showed a similar frequency of some lifestyle, such as adequate physical activity. In conclusion, in a European country with a well-developed, free-access healthcare system, achievement of many cardiometabolic goals among hypertensives is poor. Moreover, a serious deficiency in hypertension awareness and in the effectiveness of some lifestyle interventions among aware hypertensives is present. Greater effort is needed in the management of coexisting risk factors and on lifestyle medical advice to improve the cardiometabolic health of hypertensives.
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and Hypertension Unit, Hospital Doce de Octubre, c/Arzobispo Morcillo 2, 28029 Madrid, Spain. joseramon.banegas@uam.es
authors.forename: José R
authors.initials: JR
authors.lastname: Banegas
authors.forename: Auxiliadora
authors.initials: A
authors.lastname: Graciani
authors.forename: Juan J
authors.initials: JJ
authors.lastname: de la Cruz-Troca
authors.forename: Luz M
authors.initials: LM
authors.lastname: León-Muñoz
authors.forename: Pilar
authors.initials: P
authors.lastname: Guallar-Castillón
authors.forename: Antonio
authors.initials: A
authors.lastname: Coca
authors.forename: Luis M
authors.initials: LM
authors.lastname: Ruilope
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001364:Awareness; D001786:Blood Glucose; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin; D006040:Goals; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D015431:Weight Loss
chemical_list: D000959:Antihypertensive Agents; D001786:Blood Glucose; D006442:Glycated Hemoglobin