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[Risk factor control in the hypertensive patients with chronic ischemic heart disease attended in cardiologic
V Barrios1, C Escobar, V Bertomeu
1En representación de la sección de Cardiología Clínica y Extrahospitalaria de la Sociedad Española de Cardiología. vbarriosa@meditex.es
Insights
Despite widespread medication use, cardiovascular risk factors remain poorly controlled in hypertensive patients with chronic ischemic heart disease. This highlights a critical gap in managing high-risk individuals effectively.
Area of Science:
- Cardiology
- Hypertension Management
- Ischemic Heart Disease
Context:
- Hypertension and chronic ischemic heart disease (CIHD) are significant cardiovascular risk factors.
- Effective management of these conditions is crucial for preventing adverse cardiac events.
- Outpatient management by cardiologists is a key setting for addressing these risks.
Purpose:
- To assess the clinical management and control rates of cardiovascular risk factors in hypertensive outpatients with CIHD.
- To evaluate the effectiveness of current therapeutic strategies in this high-risk population.
Summary:
- The CINHTIA study surveyed 2,024 hypertensive patients with CIHD.
- Despite high rates of antihypertensive, lipid-lowering, and antidiabetic drug use, control rates for blood pressure (40.5%), LDL cholesterol (30.6%), and fasting glucose (26.6%) were low.
- Dyslipidemia (78.4%) and diabetes (32.3%) were prevalent comorbidities.
Impact:
- Current management strategies for hypertensive patients with CIHD are suboptimal in controlling key cardiovascular risk factors.
- There is a need for improved therapeutic approaches and adherence to guidelines to reduce cardiovascular risk in this vulnerable population.
Objective:
The CINHTIA study is a cross-sectional and multicentre survey designed to assess the clinical management of the hypertensive outpatients with chronic ischemic heart disease attended by cardiologists.
Patients And Methods:
Patients > or = 18 years, with a diagnosis of hypertension and chronic ischemic heart disease, were included in the study. Patients with an acute coronary syndrome within the three months prior to the inclusion were excluded. Good blood pressure (BP) control was considered < 140/90 mmHg, < 130/80 mmHg for diabetics (ESH-ESC 2003). LDL cholesterol (LDL-c) < 100 mg/dl (NCEP-ATP III) and fasting glucose between 90 and 130 mg/dl (ADA 2005) were considered as good control rates.
Results:
A total of 2,024 patients (66.8+/-10.1 years; 31.7% women) were included in the study. Systolic BP was 142.7 +/- 17.9 mmHg and diastolic BP 81.8 +/- 11.3 mmHg. 78.4% of the patients had dyslipidemia and 32.3% diabetes. Almost all the patients (99.7%) were taking at least one antihypertensive drug, beta blockers being the most frequent (67.1%). A total of 74.9% of the patients were taking lipid lowering drugs and 27.9% antidiabetics. BP was controlled in 40.5% of the patients, LDL-c in 30.6% of the dyslipidemic subgroup and fasting glucose in 26.6% of the diabetics.
Conclusions:
In this high-risk population, the control rates of risk factors continues to remain low even though the majority of patients were taking several drugs.
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