Blood pressure (BP) control is reported to be poor in hypertensive patients worldwide.
BP levels, the rate of BP control, prevalence of risk factors and total cardiovascular risk were assessed in a large cohort of hypertensive patients, derived from recent surveys performed in Italy.
Fifteen studies on hypertension, performed in different clinical settings (general population, general clinical practice, specialist outpatient clinics and hypertension centres) over the past decade were considered.
The overall sample included 52 715 hypertensive patients (26 315 men and 26 410 women, mean age 57.3 ± 6.9 years). Despite the high percentage of patients on stable antihypertensive treatment (n = 36 556, 69%), mean systolic and diastolic BP levels were 147.8 ± 8.5 and 89.5 ± 5.2 mmHg, respectively. On the basis of the nature of the study (population surveys or clinical referrals), systolic BP levels were consistently higher than the normality threshold in both settings (142.6 ± 12.4/84.8 ± 3.7 mmHg and 150.4 ± 4.6/91.9 ± 4.1 mmHg, respectively). The BP stratification could be assessed in 40 829 individuals: 4.5% had optimal, 9.2% normal and 8.3% high-normal BP levels, however, the large majority were in grade 1 (39%) or grades 2–3 (32.6%) hypertension. In the overall sample, 55.9% of hypertensive patients had hypercholesterolemia, 28.7% were smokers, 36.4% were overweight or obese and 15.0% had diabetes mellitus. Cardiovascular risk stratification was assessed in 37 813 hypertensives: 23.2% had low, 33.9% moderate, 30.2% high and 12.7% very high added risk.
Our analysis demonstrates the persistence of poor BP control and high prevalence of risk factors, supporting the need for more effective, comprehensive and urgent actions to improve the clinical management of hypertension.
aDivision of Cardiology, II Faculty of Medicine, University of Rome ‘La Sapienza’ Sant'Andrea Hospital, Rome
bIRCCS Neuromed – Pozzilli (IS)
cDepartment of Clinical Medicine and Cardiovascular Sciences, University of Naples ‘Federico II’, Naples
dDepartment of Medical and Surgical Sciences, II Division of Medicine, Azienda Ospedaliera Spedali Civili, Brescia
eDivision of Internal Medicine, Department of Clinical Medicine and Applied Biotechnology ‘D. Campanacci’
fDivision of Internal Medicine Division, University of Bologna, Policlinico Sant'Orsola, Bologna
gAssociation for Cardiac Research, Rome
hCentro Auxologico Italiano, and Centro Interuniversitario di Fisiologia Clinica e Ipertensione, IRCCS Ospedale Maggiore, Milan
iUniversity of Milano-Bicocca, Ospedale San Gerardo di Monza, Monza, Italy
Received 22 December, 2006
Revised 5 February, 2007
Accepted 9 February, 2007
Correspondence to Massimo Volpe, Division of Cardiology, II Faculty of Medicine, University of Rome ‘La Sapienza’, Sant'Andrea Hospital, Via di Grottarossa, 1035–9, 00189 Rome, Italy Tel: +39 06 3377 5561; fax: +39 06 3377 5061; e-mail: email@example.com
Endorsements: This work was endorsed by the Italian Society of Hypertension (SIIA) and Italian Society of Cardiovascular Prevention (SIPREC).