Blood pressure ( BP) control remains unsatisfactory worldwide. Better knowledge of BP management in clinical practice is needed to develop more effective improving strategies. Using a large Italian primary care database, we selected the subjects diagnosed with hypertension, and extracted the diagnosis of myocardial infarction, angina pectoris/coronary disease, stroke/transitory ischemic attack (TIA), heart failure, atrial fibrillation, peripheral arterial disease, diabetes mellitus, the serum total cholesterol, HDL cholesterol, triglycerides, creatinine, BP, electrocardiogram, weight, height and the prescription of cardiovascular ( CV) drugs. Hypertension was recorded in 119.065 individuals (prevalence 19.3%), 19.134 (16%) had no ambulatory visit and 33.183 (27.8%) had no BP value recorded. Overall, 14.594 (21.9%) had at least one recorded diagnosis showing high CV risk. BP was controlled (mean of BP values <140/90 mm Hg) in 28.918 patients (16.690 women, 12 189 men and 40 gender not recorded), that is, 43.23% of the subjects with recorded BP. Among the non-controlled patients, 21.866 (57.8%) were non-high risk grade 1 (mean BP 142.5/84.5 mm Hg; s.d. 13.1/8.2) and 7.123 (18.8%) high-risk grade 1 hypertensives (mean BP 150/83 mm Hg; s.d. 6.2/7.2). Less than three drugs were prescribed in 29.919 (79.1%) of non-controlled patients. Low attendance rate, BP under-recording and suboptimal use of politherapy are major obstacles to hypertension control. Most uncontrolled individuals are low-CV risk, grade 1 hypertensive patients, for whom the personal benefit of adding another drug is modest. Aiming at the recommended BP target in uncontrolled grade 2-3 hypertensive/high-CV risk patients would probably require two additional drugs. Journal of Human Hypertension (2009) 23, 758-763; doi: 10.1038/jhh.2009.14; published online 26 February 2009
Filippi, A., Paolini, I., Innocenti, F., Mazzaglia, G., Battaggia, A., Brignoli, O. (2009). Blood pressure control and drug therapy in patients with diagnosed hypertension: A survey in Italian general practice. JOURNAL OF HUMAN HYPERTENSION, 23(11), 758-763 [10.1038/jhh.2009.14].
Blood pressure control and drug therapy in patients with diagnosed hypertension: A survey in Italian general practice
Mazzaglia G;
2009
Abstract
Blood pressure ( BP) control remains unsatisfactory worldwide. Better knowledge of BP management in clinical practice is needed to develop more effective improving strategies. Using a large Italian primary care database, we selected the subjects diagnosed with hypertension, and extracted the diagnosis of myocardial infarction, angina pectoris/coronary disease, stroke/transitory ischemic attack (TIA), heart failure, atrial fibrillation, peripheral arterial disease, diabetes mellitus, the serum total cholesterol, HDL cholesterol, triglycerides, creatinine, BP, electrocardiogram, weight, height and the prescription of cardiovascular ( CV) drugs. Hypertension was recorded in 119.065 individuals (prevalence 19.3%), 19.134 (16%) had no ambulatory visit and 33.183 (27.8%) had no BP value recorded. Overall, 14.594 (21.9%) had at least one recorded diagnosis showing high CV risk. BP was controlled (mean of BP values <140/90 mm Hg) in 28.918 patients (16.690 women, 12 189 men and 40 gender not recorded), that is, 43.23% of the subjects with recorded BP. Among the non-controlled patients, 21.866 (57.8%) were non-high risk grade 1 (mean BP 142.5/84.5 mm Hg; s.d. 13.1/8.2) and 7.123 (18.8%) high-risk grade 1 hypertensives (mean BP 150/83 mm Hg; s.d. 6.2/7.2). Less than three drugs were prescribed in 29.919 (79.1%) of non-controlled patients. Low attendance rate, BP under-recording and suboptimal use of politherapy are major obstacles to hypertension control. Most uncontrolled individuals are low-CV risk, grade 1 hypertensive patients, for whom the personal benefit of adding another drug is modest. Aiming at the recommended BP target in uncontrolled grade 2-3 hypertensive/high-CV risk patients would probably require two additional drugs. Journal of Human Hypertension (2009) 23, 758-763; doi: 10.1038/jhh.2009.14; published online 26 February 2009File | Dimensione | Formato | |
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