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Cardiovascular risk factors in treated hypertensives--a nation-wide, cross-sectional study in Sweden
P Nilsson1, D K Andersson, P E Andersson
1Health Sciences Centre, Lund University, Dalby, Sweden.
Insights
Treated hypertensive patients in Sweden exhibit significant residual cardiovascular disease risk factors, including uncontrolled blood pressure and abnormal lipid levels. This highlights the need to reassess current management strategies for hypertension.
Area of Science:
- Cardiology
- Metabolic Disorders
- Public Health
Background:
- Hypertension treatment often fails to eliminate cardiovascular disease (CVD) risk.
- Metabolic disturbances, linked to hypertension and its treatments, contribute to this residual risk.
Purpose of the Study:
- To evaluate residual CVD risk factors in treated hypertensive patients in Sweden.
- To assess the prevalence of metabolic disturbances and other risk factors in this population.
Main Methods:
- Cross-sectional study of 1915 treated hypertensive patients (912 males, 1003 females) across 128 Swedish health centers.
- Data collected on blood pressure, lipid profiles (total cholesterol, HDL-cholesterol, triglycerides), smoking status, and diabetes mellitus prevalence.
Main Results:
- A significant proportion of patients had uncontrolled blood pressure (diastolic BP ≥ 100 mmHg: 17% males, 12% females).
- High prevalence of hypercholesterolemia (38%) and hypertriglyceridemia (27%) was observed.
- Prevalence of smoking was 25% (males) and 24% (females); diabetes mellitus was 11% (males) and 9% (females).
Conclusions:
- Treated hypertensive patients in Sweden demonstrate significant residual CVD risk factors.
- These findings underscore the need for re-evaluation of current hypertension management and care protocols.
- Addressing metabolic disturbances and lifestyle factors is crucial for reducing future cardiovascular risk.
Abstract:
Hypertensive patients still face a considerable risk of cardiovascular disease in spite of drug treatment in many studies. This may partly be explained by metabolic disturbances, both primarily linked to hypertension but also secondarily influenced by anti-hypertensive drugs themselves. In order to evaluate residual cardiovascular risk factors we investigated 1915 treated hypertensives (912 males, 1003 females) attending 128 health centres from all parts of Sweden. Mean blood pressure was 148/91 mmHg for males and 151/90 for females, but a substantial proportion of all patients were not well controlled, having a diastolic blood pressures > or = 100 mmHg (17% males, 12% females). Total cholesterol and HDL-cholesterol were 6.03 and 1.25 mmol l-1 for males, and 6.40 and 1.50 for females. The corresponding figures for serum triglycerides were 2.03 and 1.72 mmol l-1, respectively. In all, 38% of the hypertensives had hypercholesterolaemia (> or = 6.5 mmol l-1) and 27% hypertriglyceridaemia (> or = 2.3 mmol l-1). The lipid/lipoprotein findings may also be influenced by the various anti-hypertensive drugs used in Sweden. The prevalence of smoking and diabetes mellitus were 25% and 11% for men, and for women 24% and 9%. In conclusion, Swedish hypertensives show evidence of significant residual cardiovascular risk factors in spite of treatment. This may be of importance for future relative and absolute cardiovascular risk. It is time to re-evaluate the effectiveness of our management and care of hypertensive patients.