Cholesterol levels in untreated Spanish hypertensive patients. The Compas Study Group, Spanish Hypertension Society

Prevalence of Atherogenic Dyslipidemia in Spanish Hypertensive Patients and Its Relationship With Blood Pressure Control and Silent Organ Damage

INTRODUCTION AND OBJECTIVES

To assess the prevalence of atherogenic dyslipidemia in hypertensive patients and its relationship with risk profile and blood pressure control.

METHODS

The study included 24 351 hypertensive patients from the Spanish Ambulatory Blood Pressure Monitoring Registry. Atherogenic dyslipidemia was defined as the presence of hypertriglyceridemia (> 150mg/dL) and low levels of high-density lipoprotein cholesterol (< 40mg/dL in men and < 46mg/dL in women). Blood pressure control was assessed by office and ambulatory monitoring.

RESULTS

Atherogenic dyslipidemia was present in 2705 patients (11.1%). Of these, 30% had hypertriglyceridemia and 21.7% had low levels of high-density lipoprotein cholesterol. Compared with patients without these risk factors, the former group were more often male (60% vs 52%), younger (57 years vs 59 years), had other risk factors and organ damage (microalbuminuria, reduced estimated glomerular filtration rate, and left ventricular hypertrophy), worse office, diurnal, and nocturnal blood pressure values (odds ratio 1.09, 1.06, and 1.10, respectively), and the lowest nocturnal blood pressure reduction (odds ratio=1.07), despite the greater use of antihypertensive drugs.

CONCLUSIONS

Atherogenic dyslipidemia is present in more than 10% of hypertensive patients and is associated with other risk factors, organ damage, and poorer blood pressure control. Greater therapeutic effort is needed to reduce overall risk in these patients.

Tratamiento y control del riesgo cardiovascular en atención primaria en España. Estudio PREVENCAT

BACKGROUND AND OBJECTIVE

The PREVENCAT study was designed to estimate the control of the main cardiovascular risk factors (CVRF) and their treatment in a sample of population having the diagnoses of hypertension (HT), type 2 diabetes mellitus (DM2) or hypercholesterolemia (HC) who was attended by primary care physicians in Spain.

PATIENTS AND METHOD

Cross-sectional study in patients with HT, DM2 and/or HC, who were consecutively recruited. We describe the treatments for HT, DM2 and HC and analyze and the association between several potential predictors and the control of these CVRF.

RESULTS

2,649 patients were included in the study. 95% of HT patients were under treatment, as were 84% of DM2 and 71.4% of HC patients; most common drugs were diuretics, sulphonylureas and statins, respectively. Monotherapy was more frequent than combined therapy for hypertension treatment. The frequency of HT and DM2 treatment was similar among the subgroups defined by the presence or absence of the other two diagnoses. However, HC treatment was more common in the presence of DM2 (p = 0.001). Age, previous cardiovascular disease (CVD), DM2, obesity and sedentarism were all predictors of poor blood pressure control despite drug treatment. Age, previous CVD, HT and sedentarism were predictors of poor HC control.

CONCLUSIONS

CVRF treatment was high although heterogeneous and not based on the best available evidence. DM2, previous CVD and obesity were associated with insufficient blood pressure control.

Estudio PREVENCAT: control del riesgo cardiovascular en atención primaria

BACKGROUND AND OBJECTIVE

Most studies of cardiovascular risk factors (CVRF) conducted in our environment concentrate in a single CVRF. The PREVENCAT study was designed to estimate the control of CVRF in the population attended in primary care presenting arterial hypertension (HT), type 2 diabetes mellitus (DM2) and/or hypercholesterolemia (HC) as well as to assess the prevalence of Metabolic Syndrome in these patients.

PATIENTS AND METHOD

Multicenter, cross-sectional study, in patients with HT, DM2 and/or HC, consecutively recruited by primary care physicians in Spain. The blood pressure, cholesterol, basal glycaemia, obesity, smoking and physical activity were assessed. The degree of control of these CVRF and the prevalence of MS were estimated.

RESULTS

2,649 patients were recruited, aged 64 (11.3) years, with a 51.6% of women. The most frequent diagnosis was HT (78.9%), followed by HC (58.4%) and DM2 (37.4%). In the whole sample, the percentages of patients who had a control or had initially normal values of blood pressure, cholesterol and basal glycemia were 40.0% (confidence interval [CI], 95% 38.2-41.9), 42.6% (95% CI, 40.5-44.7) and 62.7% (95% CI, 60.8-64.5), respectively. 15.6% of cases (95% CI, 14.3-17.0) had body mass index < or = 25 kg/m2; 87.5% were non-current smokers (95% CI, 86.2-88.8); and 46.2% practiced regular physical activity (95% CI, 44.3-48.1). 40% of patients had < or = 2 CVRF in good control. The prevalence of metabolic syndrome was 50.6% (95% CI, 48.7-52.5).

CONCLUSIONS

The control of the CVRF considered in primary care attended population is insufficient. Hardly one of each 2 patients with HT, DM2 and HC is under control. The overweight and sedentarism control is still poorer.