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[Problems of insufficient control of target blood pressure levels in the outpatient practice]
V N Larina1, E V Fedorova1, M P Mikhailusova1
1Pirogov Russian National Research Medical University.
Insights
Achieving target blood pressure (BP) in hypertensive outpatients is low (31.3%), particularly in men with obesity and comorbidities. Dyslipidemia positively impacts BP control, highlighting areas for improved hypertension management.
Area of Science:
- Cardiology
- Hypertension Research
- Public Health
Background:
- Arterial hypertension (AH) is a significant global health concern.
- Effective blood pressure (BP) control is crucial for preventing cardiovascular complications.
- Understanding factors influencing target BP achievement in outpatients is essential for optimizing treatment strategies.
Purpose of the Study:
- To assess the frequency of achieving target blood pressure (BP) levels in outpatients with arterial hypertension (AH).
- To identify factors associated with achieving target BP in this population.
Main Methods:
- An open, comparative study involving 64 hypertensive patients and 47 controls (aged 40-59).
- Methods included physical examination, cardiovascular risk (CVR) assessment, 24-hour ambulatory blood pressure monitoring (ABPM), echocardiography (ECHOCG), and color duplex scanning of brachiocephalic arteries.
- Statistical analysis identified factors affecting target BP achievement.
Main Results:
- Only 31.3% of hypertensive patients reached their target BP, with higher rates in women.
- Male gender, obesity, and concomitant pathologies were negatively associated with target BP achievement (p<0.05).
- Dyslipidemia showed a positive association with achieving target BP (OR 0.10, p=0.033).
- Patients with AH exhibited higher SCORE scores and increased prevalence of atherosclerosis compared to controls.
Conclusions:
- Target BP is achieved in a minority (31.3%) of hypertensive outpatients.
- Obesity, male gender, and comorbidities negatively impact BP control.
- Dyslipidemia is a positive factor in achieving target BP, warranting consideration in treatment plans.
- These findings underscore the need for tailored interventions to improve hypertension management.
Aim:
Assessment of the frequency of reaching the target level of blood pressure (BP) and the factors affecting it in outpatients with arterial hypertension (AH).
Materials And Methods:
An open, one-stage, comparative study involving 64 patients with hypertension and 47 without hypertension at the age of 40 to 59 years. All patients underwent physical examination, assessment of cardiovascular risk (CVR), 24-hour blood pressure monitoring (ABPM), echocardiography (ECHOCG), color duplex scanning of brachiocephalic arteries.
Results:
Patients with hypertension and comparison groups were comparable in age, sex, smoking, history of myocardial infarction. 1st degree of hypertension was present in 26.6%, 2nd in 40.6%, 3rd in 12.5% of patients. Obesity was detected in 24.3% of patients and all patients with obesity had AH. The SCORE score in individuals with hypertension was 4.94.5; in the comparison group, 2.32.6 (p0.001). Non-stenosing atherosclerosis was present in 54.8% and 88%, p=0.020, and atherosclerotic plaque in the vascular lumen was present in 45.3% and 12% of patients with and without hypertension, respectively (p0.001). 68.8% were constantly treated, and the target BP was reached in 31.3% of patients with hypertension. Male gender (OR 1.68; 95% CI 1.6828.49; p=0.007), obesity (OR 4.78; 95% CI 1.1420.29; p=0.033), concomitant pathology (OR 3.09; 95% CI 1.029.37; p=0.046) were negative, and dyslipidemia (OR 0.10; 95% CI 0.010.84; p=0.033) was positive, affecting the achievement of the target level of blood pressure.
Conclusion:
The target level of blood pressure was achieved in 31.3% of outpatients with hypertension, mainly in women. Among patients who did not reach the target level of blood pressure, men, individuals with high SSR and obesity predominated. Concomitant pathology and obesity are negative, and dyslipidemia was positively associated with the achievement of the target level of blood pressure, which must be taken into account when developing measures for prevention and treatment.
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