title: Prevalence and management of hypertensive patients in clinical practice: Cross-sectional registry in five countries outside the European Union.
abstract: Inadequate blood pressure (BP) control may be linked with poor adherence to guidelines by the treating physician. This study aimed at assessing the rates of controlled hypertension as per the 2009 Reappraisal of the 2007 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines in 2185 hypertensive adults across five countries (Algeria, Pakistan, Ukraine, Egypt and Venezuela). The rates of controlled hypertension according to physician perception, type of therapy and risk factors were evaluated. Overall, 40% of patients had controlled hypertension according to the guidelines. A marked divergence in the rates of controlled hypertension as assessed by physicians and guidelines was observed (72% vs 40%). The presence of high/very high risks was linked to poor BP control. High salt intake [29%; odds ratio (OR) 9.94, 95% confidence interval (CI) 6.72;14.69], treatment non-adherence (27%; OR 7.32, 95% CI 4.82;11.13), lack of understanding of the treatment's importance (25%; OR 4.95, 95% CI 3.16;7.75), comorbidity (13%) and depression (9%; OR 10.50, 95% CI 5.37;20.54) were major reasons for not achieving hypertension control. Addition of another drug was the most frequent medication change prescribed. Poor rates of BP control warrant repeated promotion of guidelines while identifying potential contributing factors and implementing strategies that re-establish BP control.
authors.affiliation: a Inserm, CIC1402 , Poitiers , France ;|b Centre d'Investigation Clinique, CHU de Poitiers , 'Poitiers , France ;|c CIC1402, Université de Poitiers , Poitiers , France ;|d UFR Médecine et Pharmacie, Université de Poitiers , Poitiers , France ;
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Ragot
authors.affiliation: e AtlanStat , Rezé , France ;
authors.forename: Mathieu
authors.initials: M
authors.lastname: Beneteau
authors.affiliation: f IciBio , Binic , France ;
authors.forename: Françoise
authors.initials: F
authors.lastname: Guillou-Bonnici
authors.affiliation: d UFR Médecine et Pharmacie, Université de Poitiers , Poitiers , France ;|g Cardiologie, CHU de Poitiers , Poitiers , France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Herpin
mesh_terms: D000328:Adult; D000368:Aged; D000462:Algeria / Q000453:epidemiology; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D004534:Egypt / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D010349:Patient Compliance / Q000523:psychology; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage*; D014455:Ukraine / Q000453:epidemiology; D014687:Venezuela / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents; D017673:Sodium Chloride, Dietary
keywords: Blood pressure; fixed-dose combinations; guideline adherence; hypertension; knowledge; risk factors