BACKGROUND AND OBJECTIVE: To assess absolute cardiovascular risk and co-morbidities in uncontrolled hypertensive patients (blood pressure [BP]>or=140/90 mmHg or>or=130/80 mmHg in diabetics) attending Primary Care Physicians in Spain, and to determine the attitudes of these physicians towards this problem. PATIENTS AND METHOD: Cross-sectional, multicenter study involving 356 general practitioners around Spain. Absolute cardiovascular risk was assessed according to ESH-ESC 2003 Guidelines in a sample of 1,710 patients. RESULTS: Two hundred ninety seven patients were excluded by several reasons and a total of 1,413 hypertensive patients were valuable (mean age: 65.3+/-11.4 years; 56.7% women). Normal BP values (<140/90 mmHg) were exhibited by 0.2%, high-normal BP (120-139/80-89 mmHg) were exhibited by 2.8%, grade 1 hypertension (140-159/90-99 mmHg) by 49.9%, grade 2 hypertension (160-179/100-109 mmHg) by 39.3%, and grade 3 hypertension (>or=180/110 mmHg) by 7.9%. Associated cardiovascular risk factors were observed in 96.0% of patients (95% CI=94.7-97.2%), target organ damage in 34.5% (95% CI=31.6-36.5%), and cardiovascular clinical disease in 36.0% (95% CI=33.5-38.5%). According to ESH-ESC 2003 Guidelines 34.0% (CI=31.5-38.2%) were at very-high risk; 29.4% (95% CI=26.4-32.8%) at high risk; 30.4% (95% CI=27.2-33.7%) at moderate risk and 5.4% (95% CI=3.9-7.2%) at low risk of cardiovascular disease. Despite the high absolute risk, physicians did not do any therapeutic change in 30.4% (95% CI=28.2-33.5%) of uncontrolled hypertensive patients. Most of them (64.26%) considered that bad compliance to life style changes was the reason for inadequate BP control. The most frequent measure introduced was the association of additional drugs. CONCLUSIONS: Absolute cardiovascular risk in uncontrolled hypertensive patients attending Primary Care Physicians in Spain is very relevant. Sixty-five percent of these patients are at high or very high risk with a high prevalence of target organ damage or associated cardiovascular clinical disease. Therapeutic attitudes towards these patients are still very conservative although they are improving compared with previous studies.
BACKGROUND AND OBJECTIVE: To assess absolute cardiovascular risk and co-morbidities in uncontrolled hypertensivepatients (blood pressure [BP]>or=140/90 mmHg or>or=130/80 mmHg in diabetics) attending Primary Care Physicians in Spain, and to determine the attitudes of these physicians towards this problem. PATIENTS AND METHOD: Cross-sectional, multicenter study involving 356 general practitioners around Spain. Absolute cardiovascular risk was assessed according to ESH-ESC 2003 Guidelines in a sample of 1,710 patients. RESULTS: Two hundred ninety seven patients were excluded by several reasons and a total of 1,413 hypertensivepatients were valuable (mean age: 65.3+/-11.4 years; 56.7% women). Normal BP values (<140/90 mmHg) were exhibited by 0.2%, high-normal BP (120-139/80-89 mmHg) were exhibited by 2.8%, grade 1 hypertension (140-159/90-99 mmHg) by 49.9%, grade 2 hypertension (160-179/100-109 mmHg) by 39.3%, and grade 3 hypertension (>or=180/110 mmHg) by 7.9%. Associated cardiovascular risk factors were observed in 96.0% of patients (95% CI=94.7-97.2%), target organ damage in 34.5% (95% CI=31.6-36.5%), and cardiovascular clinical disease in 36.0% (95% CI=33.5-38.5%). According to ESH-ESC 2003 Guidelines 34.0% (CI=31.5-38.2%) were at very-high risk; 29.4% (95% CI=26.4-32.8%) at high risk; 30.4% (95% CI=27.2-33.7%) at moderate risk and 5.4% (95% CI=3.9-7.2%) at low risk of cardiovascular disease. Despite the high absolute risk, physicians did not do any therapeutic change in 30.4% (95% CI=28.2-33.5%) of uncontrolled hypertensivepatients. Most of them (64.26%) considered that bad compliance to life style changes was the reason for inadequate BP control. The most frequent measure introduced was the association of additional drugs. CONCLUSIONS: Absolute cardiovascular risk in uncontrolled hypertensivepatients attending Primary Care Physicians in Spain is very relevant. Sixty-five percent of these patients are at high or very high risk with a high prevalence of target organ damage or associated cardiovascular clinical disease. Therapeutic attitudes towards these patients are still very conservative although they are improving compared with previous studies.
Authors: M J Martínez-Orozco; Z Perseguer-Torregrosa; V F Gil-Guillén; A Palazón-Bru; D Orozco-Beltran; C Carratalá-Munuera Journal: J Hum Hypertens Date: 2014-04-03 Impact factor: 3.012
Authors: Vicente Gil-Guillén; Domingo Orozco-Beltrán; Emilio Márquez-Contreras; Ramón Durazo-Arvizu; Richard Cooper; Salvador Pita-Fernández; Diego González-Segura; Concepción Carratalá-Munuera; José Luis Martín de Pablo; Vicente Pallarés; Salvador Pertusa-Martínez; Antonio Fernández; Josep Redón Journal: Drugs Aging Date: 2011-12-01 Impact factor: 3.923
Authors: Carlos Sanchis Doménech; José Luis Llisterri Caro; Vicente Palomo Sanz; Francisco Javier Alonso Moreno; Isidro López Rodríguez; Armando Nevado Loro; Miguel Ángel Zamorano; Natividad Gil García; M Dolores Aguilar Conesa; Pablo Lázaro Y de Mercado Journal: Aten Primaria Date: 2011-03-17 Impact factor: 1.137
Authors: Emilio Márquez Contreras; Nieves Martel Claros; Vicente Gil Guillén; José Luis Martín De Pablos; Mariano De La Figuera Von Wichman; José Joaquin Casado Martínez; Jacinto Espinosa García Journal: Aten Primaria Date: 2009-05-31 Impact factor: 1.137
Authors: Isidro Rodríguez-Salceda; Esperanza Escortell-Mayor; Milagros Rico-Blázquez; Rosario Riesgo-Fuertes; Angel Asúnsolo-del Barco; Antonio Valdivia-Pérez; Isabel del Cura-González; Ana B García-Cañón; María F Ortiz-Jiménez; Luisa Cabello-Ballesteros; Sofia Garrido-Elustondo; Laura Chamorro-González; Ricardo Rodríguez-Barrientos Journal: BMC Public Health Date: 2010-07-30 Impact factor: 3.295