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Cardiovascular risk profile and blood pressure control in Italian hypertensive patients under specialist care

Mancia, Giuseppea; Volpe, Robertob; Boros, Stefanoc; Ilardi, Maurad; Giannattasio, Cristinaa

Original papers: Epidemiology and surveys

Background Information on the association between high hypertension and metabolic risk factors in Italy is limited. Furthermore, data on the rate of blood pressure control in the Italian hypertensive population are restricted to some Italian regions only, and refer usually to surveys performed, in most instances, several years ago.

Methods In the present study, a total of 4059 essential hypertensive patients were examined consecutively from March to June 2000 by 450 cardiovascular specialists (cardiologists, internists and diabetologists) operating throughout the Italian territory. Analysable data were obtained in 3812 patients.

Results Blood pressure control by treatment (< 140/90 mmHg) was infrequent (11.9%), this being particularly the case for systolic as compared to diastolic blood pressure (15.1 versus 33.7%). Hypertension was the only risk factor in only 13.7% of the patients, the association with diabetes, hypercholesterolaemia or obesity characterizing the remaining cases. About 60% of the patients fell into the high or very high cardiovascular risk category of the World Health Organization/International Society of Hypertension (WHO/ISH) Guidelines. Compared to low or moderate cardiovascular risk, multiple antihypertensive drug treatment was more frequently used in individuals at high or very high risk. These conditions were frequently underdiagnosed by physicians.

Conclusions Thus, in Italy, hypertension continues to be a poorly controlled condition. Despite being a Mediterranean country, the occurrence of hypertension is commonly associated with metabolic risk factors and often with a high or very high cardiovascular risk profile. This is not properly identified by specialist physicians.

aIstituto Auxologico Italiano IRCCS, Milano, bServizio Prevenzione e Protezione, Consiglio Nazionale delle Ricerche, Roma, cLaboratorio di Epidemiologia e Biostatistica, Istituto Superiore di Sanita', Roma, and dDuncan Farmaceutici Gruppo GSK, BUCV Risk and Metabolic GSK Group, Gruppo GlaxoSmithKline, Verona.

Correspondence and requests for reprints to Professor Giuseppe Mancia, Clinica Medica, Università Milano-Bicocca, Ospedale San Gerardo di Monza, Via Donizetti, 106, 20052 Monza (MI), Italy. Tel: +39 039 2333357; fax: +39 039 322274; e-mail:

Received 24 January 2003 Revised 5 September 2003 Accepted 16 September 2003

© 2004 Lippincott Williams & Wilkins, Inc.