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QJM Advance Access originally published online on June 27, 2005
QJM 2005 98(8):581-588; doi:10.1093/qjmed/hci091
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© The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Control of hypertension in patients at high risk of cardiovascular disease

B. Roca1, C. Suárez2, Á. Ceballos3, J.M. Varela4, F. Nonell5, J. Montes6, J. Sobrino5, A. de la Peña7 and for the CIFARC Group

From the 1Hospital General, Castellón, University of Valencia, 2Hospital de la Princesa, Madrid, 3Hospital de Antequera, Antequera (Málaga), 4Hospital Virgen del Rocío, Sevilla, 5Hospital l’Esperit Sant, Santa Coloma de Gramanet (Barcelona), 6Hospital do Meixoeiro, Vigo (Pontevedra), 7Hospital Son Llàtzer, Palma de Mallorca, Spain

Address correspondence to Dr B. Roca, Catalunya, 33-A, 4. 12004 Castellon, Spain. email: brocav{at}meditex.es

Received 3 December 2004 and in revised form 10 May 2005

Background: Hypertension is a major cardiovascular risk factor, but knowledge about the real magnitude of the problem and its determinants is lacking.

Aim: To assess control of hypertension and evaluate medical resource use, in patients at high risk of cardiovascular disease.

Design: Multicentric cross-sectional study.

Methods: We collected data for 2205 adult patients from 36 centres, representative of all regions of Spain. Patients had attended out-patient clinics from July 2002 to August 2003, had an absolute cardiovascular risk >=20% at 10 years (according to the Framingham guidelines), and had a diagnosis of hypertension. Pregnant and terminally ill patients were excluded.

Results: Hypertension was inadequately controlled in 1384 patients (62.8%). LDL cholesterol was higher in patients with uncontrolled hypertension (median 130.2 vs. 120.0 mg/dl, p < 0.001). Haemoglobin A1c in diabetic patients was also greater in those with uncontrolled hypertension (median 7.10% vs. 6.90%, p = 0.010). Uncontrolled hypertension was associated with the following variables, in descending strength of association: higher LDL cholesterol, taking antihypertensive medication, living in non-metropolitan areas, and higher body mass index.

Discussion: Hypertension is poorly controlled in most patients with a high risk of cardiovascular disease. Uncontrolled hypertension is frequently associated with poor control of other risk factors.


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