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Treatment and control of BP and lipids in patients with hypertension and additional risk factors

Verna Welch1, Simon S K Tang

  • 1Morehouse School of Medicine, Atlanta, Georgia 30310-1495, USA. vwelch@msm.edu

American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions
|October 24, 2007
PubMed

Insights

Veterans with hypertension and multiple cardiovascular risk factors received more intensive treatment but achieved lower blood pressure and cholesterol goals. Treatment strategies need adaptation to improve cardiovascular disease prevention.

Area of Science:

  • Cardiology
  • Public Health
  • Pharmacotherapy

Background:

  • NCEP ATP III guidelines suggest lipid-lowering therapy for high-risk patients, even with lower LDL-C levels.
  • ASCOT-LLA highlighted statin therapy's role in primary CVD prevention for hypertensive patients with multiple risk factors.

Purpose of the Study:

  • To analyze antihypertensive and lipid-lowering medication use in primary CVD prevention among hypertensive patients.
  • To assess blood pressure and cholesterol goal attainment rates in this population.

Main Methods:

  • Retrospective analysis of outpatient medical records from Atlanta VAMC (Oct 2001-Sep 2003).
  • Included veterans newly diagnosed with hypertension, lipids ≤240 mg/dL, and no prior coronary heart disease.
  • Patients grouped by <3 or ≥3 cardiovascular risk factors; assessed medication use and goal attainment per JNC 7 and cholesterol/HDL-C ratio <6.

Main Results:

  • 81.9% of patients with ≥3 risk factors received antihypertensives vs. 69.7% with <3 risk factors.
  • Lipid-lowering medications were prescribed to 55.3% (≥3 risk factors) vs. 33.8% (<3 risk factors).
  • Only 14.3% met both BP and lipid targets; goal attainment was lower in the ≥3 risk factor group (8.1% vs. 17.4%).

Conclusions:

  • Veterans with more cardiovascular risk factors received more intensive treatment but had lower goal attainment rates.
  • Physician strategies require adaptation to enhance lipid goal achievement in hypertensive patients.
  • Improved lipid management can further reduce cardiovascular event risk.
Abstract

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