Key result
Among adults at increased cardiovascular risk receiving antihypertensive therapy, 52% had blood pressures ≥140/90 mmHg, of whom 79% were receiving only one or two antihypertensive drug classes.
Why the study?
What proportion of high-risk adults on antihypertensive therapy have uncontrolled blood pressure, and how many drug classes are they prescribed?
Cross-Sectional (n=3,994)
Yes
What proportion of high-risk adults on antihypertensive therapy have uncontrolled blood pressure, and how many drug classes are they prescribed?
A majority of high-risk patients with uncontrolled hypertension are undertreated, receiving only one or two antihypertensive drug classes.
BACKGROUND: A significant proportion of individuals taking antihypertensive therapies fail to achieve blood pressures <140/90 mmHg. In order to develop strategies for improved treatment of blood pressure, we examined the association of blood pressure control with antihypertensive therapies and clinical and lifestyle factors in a cohort of adults at increased cardiovascular risk. METHODS: A cross-sectional study of 3994 adults from Melbourne and Shepparton, Australia enrolled in the SCReening Evaluation of the Evolution of New Heart Failure (SCREEN-HF) study. Inclusion criteria were age ≥60 years with one or more of self-reported ischaemic or other heart disease, atrial fibrillation, cerebrovascular disease, renal impairment or treatment for hypertension or diabetes for ≥2 years. Exclusion criteria were known heart failure or cardiac abnormality on echocardiography or other imaging. The main outcome measures were the proportion of participants receiving antihypertensive therapy with blood pressures ≥140/90 mmHg and the association of blood pressure control with antihypertensive therapies and clinical and lifestyle factors. RESULTS: Of 3623 participants (1975 men and 1648 women) receiving antihypertensive therapy, 1867 (52%) had blood pressures ≥140/90 mmHg. Of these 1867 participants, 1483 (79%) were receiving only one or two antihypertensive drug classes. Blood pressures ≥140/90 mmHg were associated with increased age, male sex, waist circumference and log amino-terminal-pro-B-type natriuretic peptide levels. CONCLUSIONS: Most individuals with treated blood pressures above target receive only one or two antihypertensive drug classes. Prescribing additional antihypertensive drug classes and lifestyle modification may improve blood pressure control in this population of individuals at increased cardiovascular risk.
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Campbell et al. (2012) conducted a cross-sectional in Increased cardiovascular risk and hypertension (n=3,994). Antihypertensive therapy was evaluated on Proportion of participants receiving antihypertensive therapy with blood pressures ≥140/90 mmHg. Among adults at increased cardiovascular risk receiving antihypertensive therapy, 52% had blood pressures ≥140/90 mmHg, of whom 79% were receiving only one or two antihypertensive drug classes.
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