Cor Vasa 2003, 44(11):533-541

A comparison of hypertension control and the risk profile of hypertensives in the general population and in a specialist center

Marie Jozífová^1,*, Renata Cífková¹, Zdenka Škodová¹, Eva Novozámská¹, Věra Adámková¹, Markéta Plášková¹, Ludmila Peterková¹, Věra Lánská², Rudolf Poledne³

¹ Pracoviště preventivní kardiologie

² Oddělení lékařské statistiky

³ Laboratoř pro výzkum aterosklerózy, Institut klinické a experimentální medicíny, Praha, Česká republika

Arterial hypertension affects more than a third of the middle-aged Czech population, with effective hypertension control obtained in less than 20% of hypertensives.

Aim:
To compare hypertension control and the risk profile of drug-treated hypertensives of a population sample with those of a group of hypertensives treated at a specialist center, the Department of Preventive Cardiology (DPC) of the Institute for Clinical and Experimental Medicine (IKEM).

Method:
A 1% random population sample aged 25-64 years (1,684 men and 1,763 women; respondence rates of 63.8% and 64.8 %, respectively) was examined in nine districts of the Czech Republic in 2000/2001. For the purpose of the analysis, 622 hypertensives treated with drugs by a general practitioner were selected from the sample and compared with 691 consecutive hypertensives treated for at least 3 months from July through November 2001 at the DPC IKEM.

Results:
Satisfactory hypertension control (BP < 140/90 mm Hg) was achieved in 38.1% of drug-treated population-sample patients and in 75.1% of those treated at the DPC IKEM (p < 0.001). The groups differed significantly in the number of antihypertensive drugs used. Monotherapy with antihypertensives was used in 47.3% of population-sample patients and 19.2% of those receiving treatment at the DPC IKEM. Use of a double combination was observed in 35.0% of population--sample patients and 33.3% at the DPC IKEM. A triple combination was employed more often at the DPC IKEM (30.7% vs. 14.3%), as was a combination of four antihypertensive agents (16.8% DPC IKEM, 3.4% population). The most often used agents were beta-blockers and diuretics. Other add-on medication included, most frequently, acetylsalicylic acid (13.8% population-sample patients, 53.4% of DPC IKEM patients; p < 0.001) and statins (5.0% in the population; 47.9% at the DPC IKEM; p < 0.001). The risk profile was more favorable in the series treated at the specialist center: total cholesterol, LDL-cholesterol, triglycerides and BMI were significantly lower in patients treated at the DPC IKEM compared with the population of either sex. In addition, men treated at the specialist center showed lower glycemia and a smaller waist-to-hip ratio.

Conclusion:
Hypertension control and the risk profile were more favorable in the group of patients treated at the specialist center. The likely reasons for this include more aggressive antihypertensive therapy, control of other risk factors, and a higher level of education of individuals treated at the DPC IKEM. Results suggest satisfactory control of hypertension can be obtained in up to three out of four treated patients.

Keywords: Hypertension control; Cardiovascular disease risk factors

Published: November 1, 2003  Show citation