Key result
Among hypertensive outpatients, blood pressure <130/80 mmHg was achieved in 31.1% of patients on antithrombotic therapy and 23.4% of those without, with obesity correlating with insufficient control.
Why the study?
Despite the strong link between blood pressure and hemorrhagic complications of antithrombotic therapy, the status of BP control in hypertensive patients on antithrombotics remains poorly characterized.
Does antithrombotic therapy or obesity affect the achievement of target blood pressure control in hypertensive outpatients?
Cross-Sectional (n=7,800)
No
Does antithrombotic therapy or obesity affect the achievement of target blood pressure control in hypertensive outpatients?
Absolute Event Rate: 31.1% vs 23.4%
In a real-world outpatient setting, strict blood pressure control (<130/80 mmHg) is achieved in only a minority of hypertensive patients, with obesity being a significant risk factor for poor control regardless of antithrombotic therapy use.
BP control rates were comparable with or without antithrombotic therapy; leaves open whether stricter targets or specific interventions reduce bleeding in real-world cohorts.
Background Although numerous studies have demonstrated a strong association between blood pressure (BP) and hemorrhagic complications of antithrombotic therapy, there is still a paucity of information regarding the status of BP control in hypertensive patients on antithrombotic therapy.Methods This cross-sectional, retrospective study was conducted at an outpatient clinic to examine BP control and its associated factors in hypertensive patients receiving or not receiving antithrombotic therapy.Results Of 26,803 outpatients who had scheduled visits in 2018, 7,800 hypertensive patients met the inclusion criteria, of whom 1,727 cases were on oral antithrombotic drugs. Then, target BP values were defined according to the Japanese Society of Hypertension Guidelines for the Management of Hypertension 2019. While BP values <140/90 mmHg were observed in 63.0% and 61.6% of patients with and without antithrombotic therapy, respectively, only 31.1% and 23.4% of them displayed BP values <130/80 mmHg. Multivariable logistic analysis indicated that comorbidity with obesity was a significant correlate of insufficient BP control (target BP <130/80 mmHg) in hypertensive patients, irrespective of antithrombotic therapy (patients with antithrombotic therapy, odds ratio (OR) = 1.690, 95% confidence interval (CI) = 1.351–2.113; patients without antithrombotic therapy, OR = 1.475, 95% CI = 1.290–1.687).Conclusion The majority of patients exhibited BP values <140/90 mmHg, whereas BP values <130/80 mmHg were achieved only in a small proportion of the patients. Furthermore, obesity appeared to be one of the factors contributing to insufficient BP control in a real-world setting.
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Odaguchi et al. (2020) conducted a cross-sectional in Hypertension (n=7,800). Oral antithrombotic therapy vs. No antithrombotic therapy was evaluated on Blood pressure <130/80 mmHg. Among hypertensive outpatients, blood pressure <130/80 mmHg was achieved in 31.1% of patients on antithrombotic therapy and 23.4% of those without, with obesity correlating with insufficient control.
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