BLOOD PRESSURE CONTROL ACCORDING TO CARDIOVASCULAR RISK FACTOR CLUSTERING: TRES 1 STUDY: PP.19.218

Abstract

Objective: To identify hypertensive patients with co-existing cardiovascular (CV) risk factors, and to evaluate the effect of these additional CV risk factors on blood pressure (BP) control. Design and Methods: Patients with newly diagnosed or established hypertension were enrolled in an observational study by 213 primary care physicians from 49 sites countrywide. Patients were followed monthly during the first 3 months, and then every 3 months until Month 12. Patient data were automatically stored on a central database via an internet-based management system. Significance was determined using Student t-test, chi-square test, or multiple logistic regression analysis, where P <0.05 was considered significant. Data are given mean ± SD or as a percentage. Results: A total of 1494 patients (36% male) aged 56.99 ± 11.34 years were recruited. At baseline, 17.2% were smokers and BMI was 29.06 ± 4.18 kg/m2 (males) and 31.36 ± 5.38 kg/m2 (females), and waist circumferences were103.64 ± 12.0 cm and 100.75 ± 14.3 cm, respectively. Overall, 11.1% had left ventricular hypertrophy diagnosed by ECG, 85.2% had dyslipidemia, 46.3% had impaired fasting glucose, 13.9% had an impaired oral glucose tolerance test, 73.1% were obese (BMI more than 30 kg/m2), 36.3% had diabetes mellitus (DM), 16.8% a family history of cardiovascular events, and 10.2% had microalbuminuria. BP control (less than 140/90 mmHg) in patients with DM was 57.4%. Patients were classified into the following four groups: 1) no risk factor, 2) 1–2 risk factors, 3) 3 or more risk factors, 4) DM. BP control goal attainment was lower in patients with 3 or more risk factors or DM compared with patients with no additional risk factors, or with 1–2 risk factors (P < 0.007) (Figure). Conclusion: In hypertensive patients, BP control was worse in patients with 3 or more CV risk factors or DM compared with patients with no risk factors or 1–2 additional risk factors.