Cardiovascular risk factors are not treated to target in hypertensive patients in primary care

Abstract

The awareness and control of cardiovascular risk factors other than blood pressure in hypertensive subjects in primary healthcare is not well described. This was examined by data extraction from electronic records from a random sample (115 women and 85 men) corresponding to two-thirds of all hypertensive subjects within a well-defined geographic area in Sweden. Target blood pressure (<140/90 mmHg, <130/80 mmHg if diabetes or kidney disease) was achieved in 27%, and lipid levels (total and LDL-cholesterol <5 and <3.0 mmol/l, respectively) in 42%. Beta-blockers were the most common antihypertensive drug class; 39% were given lipid lowering drugs. The distributions of antihypertensive and lipid lowering drugs were similar across gender and age groups. Patient records often contained information on body mass index, lipid levels, diabetes, left ventricular hypertrophy, microalbuminuria, and smoking habits (reported in 89%, 89%, 73%, 67%, 62% and 61%), but rarely on physical exercise, family history, concurrent cardiovascular disease or alcohol habits (reported in 47%, 46%, 39% and 18%). In conclusion, hypertensive patients in primary healthcare do not have well controlled blood pressure and lipids. The awareness and documentation of several cardiovascular risk factors is low. Improvement in risk assessment and treatment may have substantial effects on prognosis.