title: The impact of cardiovascular risk-factor profiles on blood pressure control rates in adults from Canada and the United States.
abstract: BACKGROUND
  It is unclear whether blood pressure control varies across the spectrum of atherosclerotic risk.
  
  
  METHODS
  We used data from nonpregnant adults who had fasted laboratory samples drawn for the 2007-2009 cycle of the Canadian Health Measures Survey (CHMS) or the 2005-2008 US National Health and Nutrition Examination Survey (NHANES).
  
  
  RESULTS
  The 1692 CHMS subjects and 3541 NHANES participants were demographically similar (aged a mean of 45 years), although NHANES participants exhibited higher obesity rates (33.8% vs. 22.2%, P < 0.001). Over 80% of CHMS and NHANES subjects with hypertension had at least 1 other cardiovascular risk factor. As the number of atherosclerotic risk factors increased, hypertension prevalence increased, but blood pressure control rates improved (from 48% among hypertensives with no other risk factors in CHMS to 77% among those with 3 or more risk factors, and from 35% to 53% in NHANES). However, the converse was not true: The distribution of Framingham risk scores for those subjects with "controlled hypertension" was nearly identical to the distribution among those adults with uncontrolled hypertension in both CHMS and NHANES and substantially higher than scores in normotensive subjects.
  
  
  CONCLUSIONS
  Although control of blood pressure was better in patients with multiple atherosclerotic risk factors, hypertensives with controlled blood pressures exhibited risk-factor profiles similar to those of participants with uncontrolled blood pressures. This suggests the need, in educational messaging and therapy decision making, for an increased focus on total atherosclerotic risk rather than just blood pressure control.
authors: Division of General Internal Medicine, University of Alberta, Edmonton, Alberta, Canada. Finlay.McAlister@ualberta.ca
authors: Finlay A
authors: FA
authors: McAlister
authors: Cynthia
authors: C
authors: Robitaille
authors: Cathleen
authors: C
authors: Gillespie
authors: Keming
authors: K
authors: Yuan
authors: Deepa P
authors: DP
authors: Rao
authors: Steven
authors: S
authors: Grover
authors: Sulan
authors: S
authors: Dai
authors: Helen
authors: H
authors: Johansen
authors: Michel
authors: M
authors: Joffres
authors: Fleetwood
authors: F
authors: Loustalot
authors: Norm
authors: N
authors: Campbell
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000453:epidemiology; D001794:Blood Pressure / Q000502:physiology*; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology