Tocci Giuliano, Battistoni Allegra, D'Agostino Michela, Palano Francesca, Passerini Jasmine, Francia Pietro, Ferrucci Andrea, Volpe Massimo
Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy; IRCCS Neuromed, Pozzilli, Italy.
Clin Cardiol. 2015 Jan;38(1):39-47. doi: 10.1002/clc.22351.
Control of hypertension remains a major unmet need, worldwide.
To test whether the presence of hypertension may improve global cardiovascular (CV) risk stratification and achievement of therapeutic targets for CV risk factors in adult outpatients in Italy.
Physicians were asked to submit data covering the first 10 consecutive adult outpatients. All data were centrally analyzed for global CV risk assessment and rates of control of major CV risk factors, mostly blood pressure (BP) levels, in different high-risk subgroups of hypertensive patients.
Overall, 1078 physicians collected data of 9864 outpatients (46.7% females, age 66.1 ± 10.3 years) with valuable data on BP levels, among which 7147 (72.5%) had a diagnosis of hypertension and 2717 (27.5%) were normotensive subjects. Hypertensive patients were older and had a higher prevalence of major risk factors, including smoking, obesity, dyslipidemia, and family history of cardiovascular disease, as well as comorbidities, than did normotensive subjects (P < 0.001 for all comparisons). Despite worse control of BP (66.9% vs 36.2%, P < 0.001), high-density lipoprotein cholesterol (40.5% vs 37.4%, P < 0.005), triglycerides (72.1% vs 67.8%, P < 0.001), and fasting plasma glucose (71.2% vs 67.0%, P < 0.005), hypertension was associated with larger availability and frequency of diagnostic examinations and greater use of antihypertensive, glucose-lowering, and lipid-lowering drugs, as well as antiplatelet agents, compared with normotension (P < 0.001).
Presence of hypertension significantly improved clinical data collection and CV risk stratification. Such an approach, however, was not paralleled by better control of major CV risk factors.
在全球范围内，高血压的控制仍然是一个尚未得到满足的主要需求。
检验高血压的存在是否可以改善意大利成年门诊患者的全球心血管（CV）风险分层以及CV危险因素治疗目标的达成情况。
要求医生提交连续10例成年门诊患者的数据。对所有数据进行集中分析，以评估全球CV风险，并分析高血压患者不同高危亚组中主要CV危险因素（主要是血压水平）的控制率。
总体而言，1078名医生收集了9864例门诊患者的数据（女性占46.7%，年龄66.1±10.3岁），这些患者有关于血压水平的有效数据，其中7147例（72.5%）被诊断为高血压，2717例（27.5%）为血压正常者。与血压正常者相比，高血压患者年龄更大，主要危险因素（包括吸烟、肥胖、血脂异常和心血管疾病家族史）以及合并症的患病率更高（所有比较的P<0.001）。尽管血压控制情况较差（66.9%对36.2%，P<0.001）、高密度脂蛋白胆固醇（40.5%对37.4%，P<0.005）、甘油三酯（72.1%对67.8%，P<0.001）和空腹血糖（71.2%对67.0%，P<0.005），但与血压正常相比，高血压与更多的诊断检查、更高的抗高血压、降糖和降脂药物以及抗血小板药物的使用频率相关（P<0.001）。
高血压的存在显著改善了临床数据收集和CV风险分层。然而，这种方法并没有伴随着主要CV危险因素的更好控制。
