Retrospective analysis of non-pharmacological factors associated with ineffective control of arterial hypertension in a clinical sample

Introduction. Arterial hypertension (HT) is the most common risk factor of cardiovascular diseases and leads to increased premature mortality. About half of HT patients do not reach the target values of blood pressure (BP). Aim: To assess the frequency of failure to achieve the target BP level and to identify non-pharmacological factors associated with inefficient BP control in a clinical sample of patients with hypertension. Material and Methods. A sequential clinical sample of patients (n = 105, 19–84 years old) with an established diagnosis of HT receiving antihypertensive therapy (AHT), was examined. Clinical data were analyzed in groups with efficient (ECHT, n = 29) and inefficient control of hypertension (ICHT, n = 76) by the time of admission to the hospital. Results. In the entire sample, the proportion of ICHT (72%) was higher compared to ECHT (28%). The groups did not differ in age, anthropometry, menopausal status in women, and duration of HT, but with an increase in the degree of hypertension, the proportion of patients with NCAH increased. There were more women in ECHT group, and there were equal proportions of men and women in ICHT group. In the ICHT group, we observed higher values of HDLC, more frequent chronic heart failure (CHF) and single atherosclerotic plaques (AP) of carotid and other peripheral arteries; in the ECHT group, the average levels of plasma glucose, glycated hemoglobin, the proportion of smokers were higher, and type 2 diabetes and multiple AP were more common. The AHT (doses, regimen, combinations) was more adequate in the ECHT group. About half of the patients received combination therapy. Conclusion. In the clinical sample, one third of HT patients receiving AHT, had blood pressure controlled to target at hospital admission. Inefficient blood pressure control was associated with male gender, a higher level of HDLC, the high degree of HT, single AP and CHF. In the efficient control group, smoking, comorbidity with type 2 diabetes, multiple AP, higher glucose levels and HbA1c were more often noted.