Abstract
ᅟThe present study comprised 17,096 Chinese hypertensive dyslipidemia patients who received lipid-lowering treatment for > 3 months in order to investigate blood pressure (BP) as well as low-density lipoprotein cholesterol (LDL-C) goal attainment rates in Chinese hypertensive dyslipidemia patients on antidyslipidemia drugs. The factors that interfered with BP, or BP and LDL-C goal attainment rates and antihypertensive treatment patterns, were analyzed. In total, 89.9% of the 17,096 hypertensive dyslipidemia patients received antihypertensive medications mainly consisting of a calcium channel blocker (CCB) (48.7%), an angiotensin receptor antagonist (ARB) (25.4%) and an angiotensin-converting enzyme inhibitor (ACEI) (15.1%). In cardiology departments, usage rates of β-blockers (19.2%) were unusually high compared to other departments (4.0–8.3%), whereas thiazide diuretics were prescribed at the lowest rate (0.3% vs 1.2–3.6%). The overall goal attainment rates for combined BP and LDL-C as well as BP or LDL-C targets were 22.9, 31.9 and 60.1%, respectively. The lowest BP, LDL-C and BP combined with LDL-C goal attainment rates were achieved in endocrine departments (19.9, 48.9 and 12.4%, respectively). Combination therapies showed no benefit particularly for BP goal achievement. A multivariate logistic regression analysis showed that age < 65 years, alcohol consumption, diabetes, coronary heart disease (CHD), cerebrovascular disease (CVD), chronic kidney disease (CKD), body mass index (BMI) ≥ 28 kg/m2 and not achieving total cholesterol goals were independent predictors for achieving BP, LDL-C or combined BP and LDL-C goals. In summary, the BP and LDL-C goal achievement rates in Chinese dyslipidemia outpatients with hypertension were low, especially in endocrine departments. Combination therapies were not associated with improvement of the goal achievement rates.Trial registrationClinical trial registration number NCT01732952
Highlights
The China Hypertension Survey of 2012–2015 revealed that 23.2% of adult Chinese people were hypertensive [1] and during 2013 and 2014 the prevalence of high total cholesterol, high low-density-lipid cholesterol, low high-density-lipid cholesterol and high triglycerides inChina were 6.9, 8.1, 20.4 and 13.8%, respectively [2]
A rise of 20 mmHg in systolic blood pressure (BP) and 10 mmHg for diastolic BP from baseline has been shown to be associated with an increased risk of stroke, but only a rise of systolic BP from baseline increased the risk of myocardial infarction (MI) [4]
Medication treatment and goal attainment rates of BP and low-density lipoprotein cholesterol (LDL-C) in the hypertensive dyslipidemia population First, we investigated the antihypertensive treatment rates in different hospital departments and found that the antihypertensive drug treatment rates were lowest in neurology (80.1%) and highest in cardiology (93.9%) departments (Fig. 1, Additional file 1: Table S1)
Summary
The China Hypertension Survey of 2012–2015 revealed that 23.2% of adult Chinese people were hypertensive [1] and during 2013 and 2014 the prevalence of high total cholesterol, high low-density-lipid cholesterol, low high-density-lipid cholesterol and high triglycerides inChina were 6.9, 8.1, 20.4 and 13.8%, respectively [2]. The China Hypertension Survey of 2012–2015 revealed that 23.2% of adult Chinese people were hypertensive [1] and during 2013 and 2014 the prevalence of high total cholesterol, high low-density-lipid cholesterol, low high-density-lipid cholesterol and high triglycerides in. It was estimated that optimally controlled BP would prevent 37% of CHD events, optimally controlled blood cholesterol would prevent 62%, and a combination of both would lead to a 76% reduction of CHD events [6]. Previous surveys revealed that the BP attainment rates of Chinese hypertension patients were as low as 18– 20% [8, 9]. The DYSIS-China [10] databank from 2012 collected data about dyslipidemia patients from mainland China and enabled us to analyze the prevalence of hypertension, BP and low-density lipoprotein cholesterol (LDL-C) goal attainments in dyslipidemia patients with concomitant hypertension. We hypothesized that differences in hospital departments might have influenced the BP and LDL-C target attainment rates in dyslipidemia patients with hypertension
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