Identifying predictors of blood pressure control in the Lebanese population - a national, multicentric survey -- I-PREDICT.

Samir G Mallat,Fariha Younes,Serena Abu Samra,Marie-Thérèse Sawaya

doi:10.1186/1471-2458-14-1142

Samir G Mallat, Fariha Younes + Show 2 more

Open Access

https://doi.org/10.1186/1471-2458-14-1142

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Abstract

BackgroundBlood Pressure (BP) is not well controlled and factors that predict BP control are not well identified in Lebanon. Improvement of hypertension management requires an understanding of patients’ characteristics and factors associated with uncontrolled BP. This national, multicentric, observational prospective study was designed to determine the predictors of BP control in patients followed up to 6 months.MethodsI-PREDICT study was conducted on 988 patients with newly diagnosed or uncontrolled hypertension. Socio-demographic and clinical characteristics were analyzed. The level of agreement between doctors’ perceptions on BP control status and JNC VII guidelines was analyzed.ResultsThe predictor associated with poor BP control was diabetes (OR = 0.17, CI = 0.10–0.28 at month-1; OR = 0.15, CI = 0.10–0.24 at month-6). The predictors associated with better BP control at month-6 were the early control of BP at month-1 (OR = 10.39, CI = 6.18–17.47) and combination therapy prescribed at baseline and month-1 (OR = 15.14, CI = 1.09–208.46, P = 0.04). In the sub-group of diabetes, the predictors that were associated with better BP control at 6 months were following diet at V1 (OR = 2.27, CI = 1.01 to 5.12) and BP control at V2 (OR = 7.34, CT = 3.83 to 14.07). The predictors that were associated with poor BP control at 6 months were middle economic class (OR = 0.036, CI = 0.16-0.94) and upper economic class (OR = 0.036; CI = 0.13-0.93).The rate of BP control was significantly higher at month 6 versus month 1 (67.52% vs 44.08%, P = 0.001). Additional analysis showed poor agreement between the doctors’ perceptions on BP control status and the guidelines.ConclusionsReaching an early BP control and combination therapy were significant predictors of better BP control, whereas diabetes was a significant predictor of poor BP control. A poor agreement between JNC VII guidelines and clinical practice was observed. I-PREDICT study identified factors that can be targeted for improving BP control.

Highlights

Blood Pressure (BP) is not well controlled and factors that predict BP control are not well identified in Lebanon
Those thresholds were based on the latest report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII) and the guidelines for the management of arterial hypertension of the European Society of Hypertension [19,20]
Recruitment A total of 1079 patients in 107 centers all over Lebanon were recruited in this survey of whom 988 were eligible for the statistical analysis (Figure 1)

Summary

Introduction

Blood Pressure (BP) is not well controlled and factors that predict BP control are not well identified in Lebanon. Improvement of hypertension management requires an understanding of patients’ characteristics and factors associated with uncontrolled BP This national, multicentric, observational prospective study was designed to determine the predictors of BP control in patients followed up to 6 months. Among patients with coronary artery disease studied in The Lebanese Interventional Coronary Registry (LICOR) in 2011, the most common reported cardiovascular risk factor was high BP reaching a prevalence of around 62.5% [11]. LICOR is in a national registry of more than 47 092 interventional events by 2011 (cardiac catheterization and percutaneous coronary intervention) from more than 40 sites across all Lebanon These results highlight the urgent need for intervention to prevent, treat and control hypertension [12]

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