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Clinical attributes, treatment, and control in hypertension (CATCH)-a French and Italian longitudinal patient
David Wu1, George Mansoor2, Christian Kempf3
1Merck &Co., Inc., Kenilworth, NJ USA ; Global Health Outcomes, Merck & Co., Inc., 600 Corporate Drive, CRB-205, Cokesbury, NJ 08833 USA.
Insights
Hypertension management is challenging as most patients have additional cardiovascular disease (CVD) risk factors. Achieving blood pressure (BP) targets is significantly harder for these patients, impacting overall CVD risk reduction.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Hypertension is a major cardiovascular disease (CVD) risk factor.
- Many hypertensive patients have co-existing CVD risk factors.
- Despite improvements, many patients do not reach target blood pressure (BP) levels.
Purpose of the Study:
- To analyze CVD risk profiles in hypertensive patients.
- To examine treatment patterns and BP goal attainment.
- To compare BP control in patients with and without additional CVD risk factors in France and Italy.
Main Methods:
- Retrospective cohort study using longitudinal patient databases (LPDs).
- Inclusion of patients prescribed antihypertensive medication in 2007 in France and Italy.
- Analysis of 147,964 French and 140,189 Italian patients.
Main Results:
- Most hypertensive patients (88% France, 83% Italy) had additional CVD risk factors, primarily age, dyslipidemia, and isolated systolic hypertension.
- Patients with hypertension and other risk factors had significantly lower odds of achieving target BP (ORs 1.38-1.41).
- BP control odds were lower for patients with associated CVD risk factors (France 0.54-1.10, Italy 0.59-1.17).
Conclusions:
- The majority of treated hypertensive patients in France and Italy possess at least one additional CVD risk factor.
- BP attainment is substantially less optimal in hypertensive patients with co-existing CVD risk factors.
- This highlights a critical challenge in managing hypertension and reducing CVD risk in real-world settings.
Introduction:
Hypertension, a risk factor for cardiovascular disease (CVD), is frequently associated with other CVD risk factors. Despite recent improvement in blood pressure (BP) control in Europe, a substantial proportion of patients fail to achieve BP targets.
Methods:
This retrospective cohort study used longitudinal patient databases (LPDs) in France and Italy to examine CVD risk profiles, treatment patterns, and BP goal attainment in hypertensive patients treated in real-world clinical practice between 2007 and 2008. Overall, 147,964 and 140,189 eligible patients from LPDs in France and Italy, respectively, were prescribed an antihypertensive medication in 2007.
Results:
Among patients with hypertension with other risk factors (France 88 %, Italy 83 %), the most prevalent risk factors were being elderly (France 66.9 %, Italy 70. 9 %), followed by hypertension combined with dyslipidemia (France 36.7 %, Italy 23.9 %) and isolated systolic hypertension (France 32.5 %, Italy 24.2 %). The odds ratios for target BP attainment were significantly (p < 0.001) higher in patients with hypertension without other risk factors vs patients with hypertension with other risk factors (1.41 [95 % confidence interval 1.35, 1.48] in France; 1.38 [1.31, 1.46] in Italy). The odds of BP control were significantly lower for patients with vs patients without an associated CVD risk factor (range 0.54 to 1.10 France; 0.59 to 1.17 Italy).
Discussion:
This study demonstrates that the majority of treated hypertensive patients in France and Italy have at least one additional CVD risk factor. Despite treatment with antihypertensive medications, blood pressure attainment was substantially less optimal in patients with an associated CVD risk factor compared to patients without an associated CVD risk factor.