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Blood pressure control in Italy: analysis of clinical data from 2005–2011 surveys on hypertension

Tocci, Giulianoa; Rosei, Enrico Agabitib; Ambrosioni, Ettorec; Borghi, Claudioc; Ferri, Claudiod; Ferrucci, Andreae; Mancia, Giuseppef; Morganti, Albertog; Pontremoli, Robertoh,i; Trimarco, Brunoa,j; Zanchetti, Albertok; Volpe, Massimoa,e

doi: 10.1097/HJH.0b013e3283535993
Reviews

Introduction: Blood pressure (BP) control is poorly achieved in hypertensive patients, worldwide.

Aim: We evaluated clinic BP levels and the rate of BP control in hypertensive patients included in observational studies and clinical surveys published between 2005 and 2011 in Italy.

Methods: We reviewed the medical literature to identify observational studies and clinical surveys on hypertension between January 2005 and June 2011, which clearly reported information on clinic BP levels, rates of BP control, proportions of treated and untreated patients, who were followed in different clinical settings (mostly in general practice, and also in outpatient clinics and hypertension centres).

Results: The overall sample included 158 876 hypertensive patients (94 907 women, mean age 56.6 ± 9.6 years, BMI 27.2 ± 4.2 kg/m2, known duration of hypertension 90.2 ± 12.4 months). In the selected studies, average SBP and DBP levels were 145.7 ± 15.9 and 87.5 ± 9.7 mmHg, respectively; BP levels were higher in patients followed in hypertension centres (n = 10 724, 6.7%; 146.5 ± 17.3/88.5 ± 10.3 mmHg) than in those followed by general practitioners (n = 148 152, 93.3%; 143.5 ± 13.9/84.8 ± 8.9 mmHg; P < 0.01). More than half of the patients were treated (n = 91 318, 57.5%); among treated hypertensive patients, only 31 727 (37.0%) had controlled BP levels.

Conclusion: The present analysis confirmed inadequate control of BP in Italy, independently of the clinical setting. Although some improvement was noted compared with a similar analysis performed between 1995 and 2005, these findings highlight the need for a more effective clinical management of hypertension.

aIRCCS Neuromed, Pozzilli, Isernia

bDepartment of Medical and Surgical Sciences, II Division of Medicine, Azienda Ospedaliera Spedali Civili, Brescia

cDivision of Internal Medicine, University of Bologna, Policlinico Sant’Orsola, Bologna

dDepartment of Internal Medicine and Public Health, University of L’Aquila, Coppito, L’Aquila

eDivision of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine, University of Rome ‘Sapienza’, Sant’Andrea Hospital, Rome

fUniversity of Milano-Bicocca, San Gerardo Hospital, Monza

gChair and Division of Internal Medicine, Hypertension Unit, Ospedale San Giuseppe, Milan

hDepartment of Internal Medicine, University of Genoa

iDepartment of Cardionephrology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa

jDepartment of Clinical Medicine and Cardiovascular Sciences, University of Naples ‘Federico II’, Naples

kIstituto Auxologico Italiano and Centro di Fisiologia Clinica e Ipertensione, University of Milano, Milan, Italy

Correspondence to Massimo Volpe, Professor, University of Rome ‘Sapienza’, Rome 00189, Italy. Tel: +39 06 3377 5654; fax: +39 06 3377 5061; e-mail: massimo.volpe@uniroma1.it

Abbreviations: ACE, angiotensin-converting enzyme; ARBs, angiotensin receptor blockers; BP, blood pressure

Received 30 October, 2011

Revised 4 February, 2012

Accepted 6 March, 2012

© 2012 Lippincott Williams & Wilkins, Inc.