Clustering of Cardiovascular Risk Factors and Blood Pressure Control Status in Hypertensive Patients

Abstract

Hypertensive patients have multiple risk factors such as chronic kidney disease (CKD) and hyperuricemia in addition to components of metabolic syndrome. The morbidity of cardiovascular diseases is expected to increase synergistically by clustering of them. In the present study, we assessed the clustering of cardiovascular risk factors and blood pressure (BP) control status in hypertensive patients. Subjects were 699 treated hypertensive patients (mean age: 65 +/- 12 years; males 297, females 402) who had been followed at National Kyushu Medical Center, Fukuoka, Japan. We assessed the status of BP control and the presence of comorbidity including obesity, diabetes mellitus (DM), dyslipidemia, CKD and hyperuricemia. Average BP level and the number of antihypertensive drugs were 133 +/- 11/74 +/- 10 mmHg and 2.0 +/- 1.1, respectively and the average number of cardiovascular risk factors was 1.5 +/- 1.1. No comorbid risk factors were found in 18.7% of the patients. On the other hand, 34.2%, 28.9% and 18.2% of the patients had one, two or more than three risk factors, respectively. There were no significant differences in BP among these groups, while patients with three or more risk factors needed a greater number of antihypertensive drugs than those with other groups. Patients with three or more risk factors group showed significantly higher body mass index, serum LDL cholesterol, triglyceride, plasma glucose and serum uric acid levels compared to those with other groups (p<0.05, respectively). They also showed significantly lower serum HDL cholesterol and estimated GFR levels compared to those in other groups (p<0.05, respectively). These results suggest that the majority of the treated hypertensive patients are complicated with additional cardiovascular risk factors and the patients with clustering risk factors required a greater number of antihypertensive drugs. Integrative management of BP as well as comorbid risk factors should be encouraged.