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High-risk patients with hypertension: Are we doing enough?
Evelyn Chiao1, John Sobolski, Russ Krienke
1Xcenda, Palm Harbor, Florida, USA.
Journal of the American Society of Hypertension : JASH
|April 23, 2010
Summary
Blood pressure control is suboptimal in high-risk patients, with only 46% achieving goals. Diabetics showed particularly low control rates (28%), highlighting a need for more aggressive hypertension management.
Area of Science:
- Cardiology
- Hypertension Management
- Public Health
Background:
- Cardiovascular disease risk is rising, particularly in patients with multiple risk factors.
- Blood pressure (BP) control remains a significant challenge, even with available treatments.
Purpose of the Study:
- To evaluate real-world blood pressure goal attainment in high-risk hypertensive patients.
- To analyze prescribing patterns of antihypertensive medications in these patient groups.
Main Methods:
- Retrospective chart review of 1,917 hypertensive patients from primary care practices (2003-2006).
- Analysis of BP control rates and medication classes based on risk factors: African-American ethnicity, diabetes, advanced age, and BMI ≥25 kg/m².
Main Results:
- Overall BP control rate was 46%, significantly lower (28%) in diabetic patients.
- Elevated systolic BP (>20 mm Hg above recommendation) occurred in 13-20% of patients.
- While 62% received ≥2 antihypertensives, high-risk groups often received ≥3 classes (26-36%).
Conclusions:
- Suboptimal BP control persists in high-risk hypertensive patients despite multiple antihypertensive options.
- Increased awareness and more aggressive treatment strategies are crucial for this population to mitigate poor outcomes.
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