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, IS, Italy.
Nutr Metab Cardiovasc Dis. 2021 Feb 8;31(2):472-480. doi: 10.1016/j.numecd.2020.10.015. Epub 2020 Oct 24.
Although hypertension guidelines highlight the benefits of achieving the recommended blood pressure (BP) targets, hypertension control rate is still insufficient, mostly in high or very high cardiovascular (CV) risk patients. Thus, we aimed to estimate BP control in a cohort of patients at high CV risk in both primary and secondary prevention.
A single-center, cross-sectional study was conducted by extracting data from a medical database of adult outpatients aged 40-75 years, who were referred to our Hypertension Unit, Rome (IT), for hypertension assessment. Office BP treatment targets were defined according to 2018 ESC/ESH guidelines as: a)<130/80 mmHg in individuals aged 40-65 years; b)<140/80 mmHg in subjects aged >65 years. Primary prevention patients with SCORE <5% were considered to be at low-intermediate risk, whilst individuals with SCORE ≥5% or patients with comorbidities were defined to be at very high risk. Among 6354 patients (47.2% female, age 58.4 ± 9.6 years), 4164 (65.5%) were in primary prevention with low-intermediate CV risk, 1831 (28.8%) in primary prevention with high-very high CV risk and 359 (5.6%) in secondary prevention. In treated hypertensive outpatients, uncontrolled hypertension rate was significantly higher in high risk primary prevention than in low risk primary prevention and secondary prevention patients (18.4% vs 24.4% vs. 12.5%, respectively; P < 0.001). In high risk primary prevention diabetic patients only 10% achieved the recommended BP targets.
Our data confirmed unsatisfactory BP control among high-risk patients, both in primary and secondary prevention, and suggest the need for a more stringent BP control policies in these patients.
尽管高血压指南强调了达到推荐血压（BP）目标的益处，但高血压控制率仍然不足，尤其是在高或极高心血管（CV）风险患者中。因此，我们旨在评估在初级和次级预防中处于高 CV 风险的患者队列中的 BP 控制情况。
通过从罗马（意大利）高血压科门诊的成年患者医疗数据库中提取数据进行了一项单中心、横断面研究，这些患者年龄在 40-75 岁之间，因高血压评估而就诊。诊室 BP 治疗目标根据 2018 ESC/ESH 指南定义为：a）年龄在 40-65 岁的个体<130/80mmHg；b）年龄大于 65 岁的患者<140/80mmHg。SCORE<5%的初级预防患者被认为是低-中危，而 SCORE≥5%或合并症患者被定义为极高危。在 6354 例患者中（47.2%为女性，年龄 58.4±9.6 岁），4164 例（65.5%）为低-中危初级预防，1831 例（28.8%）为高危-极高危初级预防，359 例（5.6%）为次级预防。在接受治疗的高血压门诊患者中，高危初级预防患者的未控制高血压率明显高于低危初级预防和次级预防患者（18.4%比 24.4%比 12.5%；P<0.001）。高危初级预防的糖尿病患者中仅有 10%达到了推荐的 BP 目标。
我们的数据证实，高风险患者的 BP 控制仍然不理想，无论是在初级预防还是次级预防中，这表明这些患者需要更严格的 BP 控制策略。
