Journal Article Ahead of print
PubMed: 42525716 DOI: 10.1093/eurjpc/zwag377
Hypertension awareness, treatment, and control in coronary heart disease patients: results of the EUROASPIRE V survey conducted in 27 countries.
Eur J Prev Cardiol
Authors: Anna Marzà Florensa, Piotr Jankowski, Ilonca Vaartjes, Kerstin Klipstein-Grobusch, Guy De Backer, Dirk de Bacquer, Kornelia Kotseva, David Wood, Renata Cifkova, Seppo Letho, Erkin Mirrakhimov, Diederick E Grobbee
Affiliations
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
- Department of Internal Medicine and Geriatric Cardiology, Centre of Postgraduate Medical Education, Warsaw, Poland.
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- Department of Public Health and Primary Care; Ghent University, Ghent, Belgium.
- National Institute for Prevention and Cardiovascular Health, National University of Galway, Galway, Ireland.
- Imperial College Healthcare NHS Trust, London, UK.
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital, 140 59 Prague, Czech Republic.
- Oulu University Hospital and Lapland Central Hospital, Finland.
- Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.
- Seoul University, Seoul, South Korea.
Abstract
AIMS
Hypertension is a highly common cardiovascular risk factor, and a large proportion of patients with coronary heart disease (CHD) have uncontrolled hypertension. We report on the distribution and determinants of hypertension awareness, treatment, and control in CHD hypertensive patients.
METHODS
The EUROASPIRE V survey included 8261 CHD patients from 27 countries. Awareness was defined as patients reporting being told by a health professional to have raised blood pressure (BP), being aware of their BP target and latest measurement. Patients using antihypertensive medication to lower BP were considered treated. Controlled hypertension was defined as BP <140/90mmHg (<140/85mmHg in patients with diabetes). Factors associated with hypertension awareness, treatment and control were identified with logistic regression.
RESULTS
A total of 6496 EUROASPIRE V patients were considered hypertensive, from which 60.4% were aware, 91.7% were on treatment, and 46.8% were controlled. Number of antihypertensive drugs and adherence were independently associated with awareness (OR 1.23, 95%CI 1.16-1.31, and 2.18, 1.74-2.74 respectively) and control (1.11, 1.05-1.17 and 1.93, 1.57-2.37 respectively). Secondary (1.32, 1.03-1.68) and tertiary (1.70, 1.32-2.17) education and undertaking lifestyle changes (1.60, 1.37-1.87) were associated with awareness. Controlled patients were more often aware (1.43, 1.23-1.65) and had a healthier risk factor profile (BMI >25kg/m2 0.73, 0.61-0.87, diabetes 0.67, 0.59-0.76, LDL ≥1.8mmol/L 0.75, 0.65-0.86) than uncontrolled patients.
CONCLUSION
Hypertension control remains poor in hypertensive CHD patients, despite high treatment and reasonable awareness levels. Communication with CHD hypertensive patients, especially those from vulnerable groups, needs to improve to facilitate change of health behaviours.
MeSH
Diabetes Mellitus, Hypertension, Heart Diseases, Heart, Cardiovascular Diseases, Secondary Prevention, Antihypertensive Agents, Coronary Disease, Risk Factors, Therapeutics