Antihypertensive treatment lowers blood pressure (BP) and reduces cardiovascular, cerebral and renal risk of hypertension. In developed countries, BP control has increased over the past few decades and is now approaching 70% of patients. Herewith we report the results of an observational study carried out on hypertensive outpatients.
In a cohort of 1,422 consecutive hypertensive outpatients (793 females, 629 males; mean age: 60.2 ± 12.3 years) evaluated from January 2015 to December 2016, the following parameters were assessed: age, sex, body-mass index (BMI), waist circumference (WC), smoking status, BP in the sitting position, estimated glomerular filtration rate (eGFR), serum glucose, glycosylated haemoglobin, lipid profile, antihypertensive drugs prescribed. In agreement with the European guidelines, hypertension was defined as sitting BP equal or higher than 140/90 mmHg or use of antihypertensive drugs. Patients whose sitting BP was lower than 140/90 mmHg were considered as having achieved BP control. Furthermore, in compliance with the new definition of hypertension suggested by the American College of Cardiology/American Heart Association (ACC/AHA), a second level of BP control (sitting BP below 130/80 mmHg) was evaluated.
Overall, 76.3% of hypertensive patients achieved BP lower than 140/90 mmHg; 51.5% of them achieved BP lower than 130/80 mmHg. In both contexts, compared with patients whose BP was not controlled, those achieving the BP targets were younger, mainly females and showed a significantly lower BMI. No differences were in WC and eGFR. With regard to the major cardiovascular risk factors (smoking, diabetes mellitus and hypercholesterolemia), only diabetes resulted significantly higher in patients not achieving BP control. Finally, all patients achieving the BP target were prescribed significantly fewer antihypertensive drugs in comparison to those in whom BP was not controlled.
More than 76% of our outpatients achieved BP target of less than 140/90 mmHg, a figure that is higher than the objective of 70% of treated and controlled hypertensive patients set in Europe. Under the new definition of hypertension proposed by ACC/AHA, only 51.5% of our patients were below the threshold of 130/80 mmHg, a result that is however better than those recently reported.
IRCCS casa sollievo della sofferenza, department of medical sciences, neprhrology and dialysis unit, San Giovanni Rotondo, ITALY