Blood pressure control in patients with hypertension: a retrospective cohort study.

Abstract

Hypertension (HT) is prevalent in Turkey and even with pharmacological interventions HT control rates do not meet guideline recommendations. We aimed to estimate the proportion of hypertensive patients who achieved target blood pressure (BP) and seek to determine the predictors responsible for failure of to reach goals. We conducted a retrospective cohort study involving patients with HT. A total of 437 patients were identified with a current diagnosis of HT at baseline. All available predictors for BP improvements were included in the multivariate linear regression model. Follow-up data on HT goal achievements was available for 276 (63.1%) participants. Only 18.1% of the patients at the baseline visit, and 48.6% at the follow-up visit achieved the overall SBP/DBP targets specified by the JNC-8 guideline. Significant differences were determined by baseline and 1st visit measurements of mean SBP/DBP levels (P < 0.001, P < 0.001, respectively). DM and baseline SBP were positively associated with SBP improvement (β = 8.410, P = 0.003; β = 0.692, P < 0.001, respectively), whereas being prescribing more HT medications and being older were negatively associated with improvement (β = -7.968, P = 0.005; β = -5.707, P = 0.037; respectively). DM, baseline DBP and HT duration were positively associated with DBP improvement (β = 4.539, P = 0.012; β = 0.702, P < 0.001; β = 0.023, P = 0.012; respectively), whereas additional HT medications and GFR values were negatively associated with improvement (β = -5.682, P = 0.002; β = -0.098, P = 0.005; respectively). Although the progress in achieving in BP targets was encouraging, only half of patients had reached the HT goals. Adequate pharmacological approaches and comprehensive management strategies should be implemented in hypertensive patients.