Author(s): Barrios Alonso V, Escobar Cervantes C, Caldern Montero A, Llisterri Caro JL, Echarri Carrillo R,
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Abstract OBJECTIVES: To determine the impact of cardiovascular disease (CVD) (heart failure, ischaemic heart disease, stroke, renal insufficiency, and peripheral arterial disease) on blood pressure (BP) and LDL-cholesterol (LDL-C) control in hypertense patients. DESIGN: We analysed the subset of patients with CVD from those included in the PRESCOT study (a cross-sectional study of hypertense patients attended in primary care). SETTING: A total of 2000 primary care physicians participated in the study. PARTICIPANTS: In an analysis of 12 954 patients (50.1\% males; aged 62.1 [10.7]), good BP control was defined as <140/90 mm Hg (<130/80 mm Hg for diabetics) and good LDL-C control, according to the ATP-III stipulations for every risk group. RESULTS: Overall, 3294 (25.43\%) patients had established CVD (mean age, 66.0 [10.2] years; 56.3\% males). Of these, 82.2\% had dyslipidaemia and 45.6\% were diabetics (vs 72.3\% and 23.9\%, respectively, in non-CVD group; P< .0001). Patients with CVD were treated with more anti-hypertensives (55.7\% vs 30.4\% were on é2 drugs; P< .001) and more lipid-lowering drugs (67.6\% vs 55.4\%, P< .001) than patients without CVD. BP was controlled in 25.3\% of patients with CVD versus 26.7\% (P=.095); and LDL-C in 13.3\% versus 40.2\% (P< .001). Only 7.0\% of patients with CVD were well controlled for both parameters versus 18.7\% of those without CVD (P< .001). The main predictive factors of poor BP control were Diabetes (OR, 1.20; 95\% CI, 1.10-1.30), sedentary lifestyle (OR, 1.19; 95\% CI, 1.11-1.29) and female gender (OR, 1.12; 95\% CI, 1.02-1.23), among others; whilst the main factors for poor LDL-C control were a family history of CVD (OR, 1.34; 95\% CI, 1.24-1.46), sedentary lifestyle (OR, 1.28; 95\% CI, 1.18-1.39), and diabetes (OR, 1.15; 95\% CI, 1.06-1.26). CONCLUSIONS: BP and LDL-C control in the hypertense population with CVD is very poor. In fact, only 7\% of these patients have both parameters well controlled.
This article was published in Aten Primaria
and referenced in Journal of Diabetes & Metabolism