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Blood pressure distribution and control in coronary patients from 24 European countries in the European Society of Cardiology EURoObservational Research Programme European survey of cardiovascular disease prevention and diabetes. EUROASPIRE IV Registry

Cífková, Renataa,b; Lánská, Věrac; Bruthans, Jana; Mayer, Otto jrd; Kotseva, Korneliae,m; Wood, Davide; Lovic, Draganf; De Sutter, Johang; Reiner, Zeljkoh; Fras, Zlatkoi,j; Deckers, Jaapk; Gotcheva, Ninal; Georgiev, Borislavl; De Bacquer, Dirkm on behalf of EUROASPIRE IV investigators

doi: 10.1097/HJH.0000000000002130
ORIGINAL PAPERS: Epidemiology
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Background: Hypertension is the most prevalent major independent risk factor for developing coronary heart disease (CHD). The present analysis aimed to assess blood pressure (BP) distribution and factors associated with insufficient BP control in coronary patients from 24 countries participating in the European Society of Cardiology (ESC) EURoObservational Research Programme (EORP) EUROASPIRE IV survey.

Methods: EUROASPIRE IV is a cross-sectional study conducted in 2012–2013 in patients aged 80 years or less hospitalized for CHD with a follow-up visit at a median of 16 months later. Logistic regression analysis was applied to confirm factors associated with BP control defined as less than 140/90 mmHg for nondiabetic patients and less than 140/85 mmHg for diabetic patients.

Results: A total of 7998 patients (response rate, 48.7%) attended the follow-up visit. Complete data were available in 7653 participants (mean age 62.5 ± 9.6 years). The BP goal was achieved in 57.6%. Patients failing to achieve the BP goal were older, had higher BMI, had more often a history of coronary artery bypass grafting (CABG) and reported diabetes more frequently. Logistic regression confirmed the following independent significant predictors of not achieving the BP goal: a history of diabetes [odds ratio (OR) 1.75], obesity (OR 1.70 vs. normal BMI), overweight (OR 1.28 vs. normal BMI), age at least 65 years (OR 1.53) and CABG as the index event (OR 1.26 vs. acute MI).

Conclusion: EUROASPIRE IV found insufficient BP control in a large proportion of patients with stable CHD, with diabetes, increased BMI, older age and CABG as the index event being independent predictors of poor BP control.

aCenter for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital

bDepartment of Medicine II, Charles University in Prague, First Faculty of Medicine

cMedical Statistics Unit, Institute for Clinical and Experimental Medicine, Prague

d2nd Department of Internal Medicine, Faculty of Medicine, Charles University, Pilsen, Czech Republic

eNational Heart and Lung Institute, Imperial College London, London, UK

fClinic for Internal Disease Intermedic, Cardiology Department, Hypertension Centre, Nis, Serbia

gDepartment of Internal Medicine, Gent University, Gent, Belgium; Department of Cardiology, AZ Maria Middelares Gent, Gent, Belgium

hUniversity Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia

iDepartment of Vascular Medicine, University Medical Centre Ljubljana, Division of Medicine, Ljubljana, Slovenia

jMedical Faculty, University of Ljubljana, Ljubljana, Slovenia

kThe Erasmus University Medical Center, Rotterdam, Netherlands

lNational Heart Hospital, Department of Cardiology, Sofia, Bulgaria

mDepartment of Public Health and Primary Care, Ghent University, Ghent, Belgium

Correspondence to Renata Cífková, Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Vídeňská 800, 140 59 Prague 4, Czech Republic. Tel: +420 2 6108 3694; fax: +420 2 6108 3821; e-mail: renata.cifkova@ftn.cz

Abbreviations: ACE, angiotensin-converting enzyme; AMI, acute myocardial infarction; BP, blood pressure; CABG, coronary artery bypass grafting; CHD, coronary heart disease; CI, confidence interval; CVD, cardiovascular disease; ESC, European Society of Cardiology; ESH, European Society of Hypertension; EUROASPIRE, EUROpean Action on Secondary and Primary prevention by Intervention to Reduce Events; GP, general practitioner; HOT, Hypertension Optimal Treatment; ICD, International Classification of Diseases; IQR, interquartile range; LV, left ventricular; MI, myocardial infarction; OR, odds ratio; PCI, percutaneous coronary intervention

Received 25 November, 2018

Revised 25 March, 2019

Accepted 26 March, 2019

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