Blood Pressure and Cholesterol Control in Hypertensive Patients With Dyslipidemia: A Cross-Sectional Epidemiological Study in Serbia (Snapshot Study)

Objective: This study aimed to assess the control rates of blood pressure (BP) and low-density lipoprotein-cholesterol (LDL-C), along with the associated cardiovascular (CV) risk, in hypertensive patients with dyslipidemia in Serbia, based on both recommendations from 2021 European Society of Cardiology CV disease prevention guidelines (SCORE2-OP), and physicians’ assessment. Design and method: SNAPSHOT, a cross-sectional observational multicenter epidemiological study, involved 97 investigators (56.7%, 19.6%, 21.6% and 2.1% were general practitioners, internist, cardiologists, and endocrinologists, respectively) in Serbia and included 1187 hypertensive patients with dyslipidemia. Results: The analysis set included 1168 patients, with a mean (standard deviation [SD]) age of 61.9 (11.3) years. Most patients were female (59.4%), overweight or obese (73.9%), and non-smokers (58.7%). Most (85.5%) patients had at least one additional risk factor and 33.9% had at least one additional CV comorbidity, mainly angina (13.4%), peripheral arterial disease (9.3%), and myocardial infarction (8.0%). Mean (SD) systolic and diastolic BP were 134.4 (15.3) and 82.3 (9.5) mmHg, respectively. Mean (SD) total cholesterol, high density lipoprotein-cholesterol, LDL-C, and triglycerides were 229.1 (49.8), 54.3 (18.4), 137.7 (44.5), and 176.4 (90.5) mg/dl, respectively. Hypertension was treated in 98.7% of patients. BP was considered controlled according to investigators in 74.8% of patients, and to guidelines in 20.9% of patients. Dyslipidemia was treated in 93.2% of patients. LDL-C was considered controlled according to investigators in 48.2% and to guidelines in 2.9% of patients. 0.70% of patients were controlled on both BP and LDL-C according to guidelines. Single-pill combination was used to treat hypertension, dyslipidemia, and both conditions in respectively 58.8%, 9.2%, and 11.9% of patients. CV risk was estimated by investigators as moderate (41.9%), high (37.9%), or very high (11.0%) for most patients. However, calculated CV risk according to guidelines was either high or very high for all patients (12.3% and 87.7%, respectively). The investigator underestimated the CV risk in 84.9% of patients. Conclusions: This study showed low control rates for BP and LDL-C. CV risk was frequently overestimated by physicians. Enhancing physician education on guideline recommendations and treatment intensification could improve risk factor control.