title: Factors associated with blood pressure control in hypertensive patients with coronary heart disease: evidence from the Chinese Cholesterol Education Program.
abstract: Blood pressure (BP) remains poorly controlled among hypertensive patients with coronary heart disease (CHD) in China. Improvement of its management will require an understanding of the patient characteristics and treatment factors associated with uncontrolled hypertension. A cross-sectional survey of 3,279 patients from 52 centers in China was performed to examine potential barriers to adequate blood pressure control of hypertensive patients with CHD. Uncontrolled hypertension was defined as blood pressure ≥130/or 80 mmHg. Multivariable logistic regression was used to identify factors associated with poor blood pressure control. Mean age of the patients was 65 years, 40% were women, and mean BMI was 25 kg/m(2). Mean systolic blood pressure was 136±18 mmHg and mean diastolic blood pressure was 80±11 mmHg. Only 18% of patients had a mean blood pressure <130/80 mmHg during the study period. Multivariate analysis revealed several independent factors of poor blood pressure control: body mass index ≥23 kg/m(2), the presence of stable angina pectoris (SAP), family history of diabetes, and use of calcium channel blockers (CCB). Further analysis showed that non-dihydropyridine calcium antagonist was significantly correlated with low BP control rate. Some of these may be amenable to modification. The results of our study suggest that overweight, the presence of SAP and family history of diabetes are important factors for tight BP control in primary care. In addition, non-dihydropyridine calcium channel blockers appear less effective than other therapies in control of blood pressure and should not be the first choice among hypertensive patients with CHD. Further identification of patients at risk of poor BP control can lead to targeted interventions to improve management.
authors.affiliation: Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Dachun
authors.initials: D
authors.lastname: Xu
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Xiankai
authors.initials: X
authors.lastname: Li
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.forename: Hou
authors.initials: H
authors.lastname: Lei
authors.forename: Yidong
authors.initials: Y
authors.lastname: Wei
authors.forename: Weiming
authors.initials: W
authors.lastname: Li
authors.forename: Dayi
authors.initials: D
authors.lastname: Hu
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Wedick
authors.forename: Jinsong
authors.initials: J
authors.lastname: Wang
authors.forename: Yawei
authors.initials: Y
authors.lastname: Xu
authors.forename: Jue
authors.initials: J
authors.lastname: Li
authors.forename: Yunsheng
authors.initials: Y
authors.lastname: Ma
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002681:China; D002784:Cholesterol / Q000097:blood*; D003327:Coronary Disease / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic
chemical_list: D002784:Cholesterol