BP VALUES AND CONTROL RATES IN A GENERAL POPULATION: IMPACT OF THE ESC-ESH AND ACC-AHA GUIDELINES

Abstract

Abstract Objective: The recent guidelines on the hypertension (HTN) management, ESC-ESH and ACC-AHA, establish different recommendations for BP goals. The impact in the rates of BP control differs among the countries based on the prevalence of HTN. The objective was to assess the rates of BP control in a Mediterranean population. Design and method: The sample was recruited from beneficiaries of the Valencian Health Agency's health care system, with a population of 3799884 people older than 25 years in 2012. The observational study was undertaken as part of routine clinical practice in data from the last 6 months of 2016. Hypertension was defined by a recorded physician diagnosis, or antihypertensive medication use. Results: Among the total population, 2552417 normotensives and 1247467 hypertensives were included. Among normotensives 123332 (4.8%) were diabetics and 45142 (1.7%) CKD. Among HTN, 387590 (31%) were diabetics and 272800 (21.8%) CKD. BP values was recorded in 46% of subject no diagnosed of HTN and 80% of HTN. According the ESH-ESC (<140/90 mmHg) and the ACC-AHA (<130/80 mmHg) criteria, distribution of subjects with BP higher that the recommended among the non-diagnosed of HTN (left figure) and the rate of control by the in the HTN (right figure), by decades of age and sex are below. Conclusions: Control rates of hypertension among subjects diagnosed varies across age and sex. Furthermore, large per cent of subjects with BP recorded were not diagnosed of hypertension neither are receiving antihypertensive treatment. The magnitude of this “diagnosed inertia” is clearly magnified, around twice, if the ACC criteria for diagnosis and goals are adopted.