Impact of the presence of cardiovascular disease on blood pressure and lipid control in the hypertense population attended in primary care

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Author list: Alonso VB, Cervantes CE, Montero AC, Caro JL, Carrillo RE, Matali A
Publisher: Elsevier España (Elsevier Doyma)
Publication year: 2008
Volume number: 40
Issue number: 1
Start page: 21
End page: 27
Number of pages: 7
ISSN: 0212-6567
Languages: English-Great Britain (EN-GB)


Abstract

Objectives. To determine the impact of cardiovascular disease (CVD) (heart failure, ischaemic heart disease, stroke, renal insufficiency, and peripheral arterial disease) on blood pressure (BP) and LDL-cholesterol (LDL-C) control in hypertense patients.Design. We analysed the subset of patients with CVD from those included in the PRESCOT study (a cross-sectional study of hypertense patients attended in primary care).Setting. A total of 2000 primary care physicians participated in the study.Participants. In an analysis of 12 954 patients (50.1% males; aged 62.1 [10.7]), good BP control was defined as < 140/90 mm Hg (< 130/80 mm Hg for diabetics) and good LDL-C control, according to the ATP-III stipulations for every risk group.Results. Overall, 3294 (25.43%) patients had established CVD (mean age, 66.0 [10.2] years; 56.3% males). Of these, 82.2% had dyslipidaemia and 45.6% were diabetics (vs 72.3% and 23.9%, respectively, in non-CVD group; P <.0001). Patients with CVD were treated with more anti-hypertensives (55.7% vs 30.4% were on >= 2 drugs; P <.001) and more lipid-lowering drugs (67.6% vs 55.4%, P <.001) than patients without CVD. BP was controlled in 25.3% of patients with CVD versus 26.7% (P=.095); and LDL-C in 13.3% versus 40.2% (P <.001). Only 7.0% of patients with CVD were well controlled for both parameters versus 18.7% of those without CVD (P <.001). The main predictive factors of poor BP control were Diabetes (OR, 1.20; 95% Cl, 1.10-1.30), sedentary lifestyle (OR, 1.19; 95% CI, 1.11-1.29) and female gender (OR, 1.12; 95% Cl, 1.02-1.23), among others; whilst the main factors for poor LDL-C control were a family history of CVD (OR, 1.34; 95% CI, 1.24-1.46), sedentary lifestyle (OR, 1.28; 95% Cl, 1.18-1.39), and diabetes (OR, 1.15; 95% Cl, 1.06-1.26).Conclusions. BP and LDL-C control in the hypertense population with CVD is very poor. In fact, only 7% of these patients have both parameters well controlled.


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Last updated on 2019-23-08 at 11:15