Cardiovascular risk in women attending primary care centres: baseline data of the EVA study

The purpose of this study was to determine the prevalence of hypertension, cardiovascular risk factors and target organ damage using baseline data from the EVA study.

EVA is a 5-year multicentre prospective study of women aged between 40 and 70 years attending primary care centres in a rural-urban area in the north of Spain. The recruitment period was between October 2009 and January 2010. The following variables were analysed: associated cardiovascular risk factors, target organ damage and cardiovascular or renal disease defined according to the 2007 European Society of Hypertension and the European Society of Cardiology Guidelines (2007 ESH/ESC 2007). Blood pressure <140/90 mmHg and <130/80 in diabetics were considered target blood pressure values. Cardiovascular risk was stratified according to the 2007 ESC-ESH guidelines.

The study sample comprised of 903 women with a mean age of 59.6 ± 8 years. The prevalence of hypertension, Type 2 diabetes and dyslipidaemia was 45.6, 13.3 and 41.7%, respectively. Target organ damage affected 17.6% of women and manifested as microalbuminuria (1.8%), slight increase in plasma creatinine (1.6%) and left ventricular hypertrophy (2.9%). Overall, 9.3% had cardiovascular disease, 3.4% coronary heart disease, 1.8% heart failure, 1.8% peripheral artery disease and 1.4% renal disease; 2.2% of patients had experienced a stroke. The prevalence of cardiovascular risk factors in hypertensive women (HT) with respect to non-hypertensive women (NHT) was as follows: obesity 44.7 versus 18.9%, dyslipidaemia 48.8 versus 35.8% and Type 2 diabetes 21.8 versus 6.1%. The target organ damage was more prevalent in hypertensive women: 27.3 versus 9.4%. Cardiovascular disease was present in 14.8% of HT and 4.7% of NHT. High or very high cardiovascular risk affected 65.3% of HT and 26.9% of NHT.

Four in 10 women attending primary care centres had a high or very high cardiovascular risk. Percentages of classic cardiovascular risk factors were higher in HT than in NHT and increased significantly with age. The most commonly used drugs were renin-angiotensin system blockers and diuretics.