title: Control of blood pressure and cardiovascular risk in Moroccan patients with newly diagnosed hypertension: a 3-month observational study in primary care.
abstract: BACKGROUND
  Control of blood pressure and reduction of cardiovascular risk factors are mandatory in patients with hypertension. The aim of this study was to determine the proportion of patients with controlled hypertension and to describe the cardiovascular risk profile in hypertensive patients followed by general practitioners (GPs) in Morocco.
  
  
  METHODS
  This national, observational, multicentre, prospective, longitudinal study of patients with newly diagnosed hypertension was carried out between September 2011 and December 2011. The use of antihypertensive drugs was evaluated at inclusion and after 3 months of follow up. Uncontrolled hypertension was defined as systolic blood pressure (SBP) ⩾ 140 mmHg or diastolic blood pressure (DBP) ⩾ 90 mmHg at 3 months of follow up. The SCORE scale issued by the European Society of Cardiology (ESC) was used to assess overall cardiovascular risk and probability of experiencing a cardiovascular event within 10 years.
  
  
  RESULTS
  A total of 909 hypertensive patients were recruited (62.4% female). Mean age was 56.8 ± 10.6 years. More than half of the patients (53.0%) were between 40-60 years and more than one-third (34.1%) were obese [body mass index (BMI) ⩾ 30 kg/m2]. There were significantly more obese females than males ( p < 0.001). Over half of the patients (52.5%) had a high or extremely high cardiovascular risk. Abdominal obesity (measured as waist circumference) was the most common cardiovascular risk factor (61.7%) followed by age (40.5%), dyslipidaemia (36.3%) and diabetes (34.3%). Mean SBP decreased from 168.1 ± 14.8 to 138.3 ± 13.2 mmHg ( p < 0.001) and mean DBP decreased from 93.0 ± 10.5 to 81.0 ± 8.6 mmHg ( p < 0.001) after 3 months of treatment. Control of blood pressure was achieved in only 46.8% of patients. Poor compliance (17.1%) and a lack of treatment efficacy (16.9%) were the two main reasons for not achieving the blood pressure target.
  
  
  CONCLUSIONS
  More than half (53.2%) of the hypertensive patients in our study did not achieve adequate blood pressure control during the 3-month follow-up period and had a high cardiovascular risk. More effective management of hypertension is required in primary care.
authors.affiliation: Private Medical Office, 264, Ghandi Street, Casablanca 20200, Morocco.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Alami
authors.affiliation: Department of Cardiology, PCIM Laboratory, FMPM, Cadi Ayyad University, Marrakesh, Morocco.
authors.forename: Mustapha
authors.initials: M
authors.lastname: El Hattaoui
authors.affiliation: Medical Affairs Department, Sanofi Maroc, Casablanca, Morocco.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Seqat
authors.affiliation: Medical Affairs Department, Sanofi Maroc, Casablanca, Morocco.
authors.forename: Jamaa
authors.initials: J
authors.lastname: Sadik
authors.affiliation: Private Medical Office, Rabat, Morocco.
authors.forename: Aicha
authors.initials: A
authors.lastname: Aouad
authors.affiliation: Nephrology Department, Ibn Rushd University Hospital, Faculty of Medicine and Pharmacy, University Hassan II, Casablanca, Morocco.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Benghanem Gharbi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D011320:Primary Health Care; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: Morocco; adults; blood pressure control; cardiovascular risk; hypertension