Lipids, blood pressure and early cardiovascular disease, need for revisit

Abstract

Aim of study was to evaluate the awareness of hypertensive patients on the presence of target organ damage. Data were collected in 1.320 hypertensive subjects (mean age 61 24 years, 611 female) consecutively referred to our Hypertension Center between November 2012 and January 2014. In this analysis we considered: creatinine serum concentration, microalbuminuria, left ventricular hypertrophy (LVH), carotid intima-media thickening (IMT) or plaques. Self-explaining questionnaires were administered to all patients in order to investigate whether they were aware of having any alterations in such variables. The questionnaire, which included quantitative and qualitative variables, was guided by a nurse or a physician. Patients were asked: Whether they knew the value of creatinine and microalbuminuria and if these were normal or pathological. If they made an EKG or echocardiography and these revealed LVH. Whether they underwent a carotid Doppler ultrasound and if it showed any alterations due to hypertension. Data obtained through the questionnaires were compared with the measurement of the same variables, obtained from the hospital data base or patients’ record-files. Results: Renal Function: increase in serum creatinine concentration (>1.2 mg/dL) was detected in the 27% of patients but 14% of them were aware of having impaired renal function. Microlabuminuria (>30 mg/g of creatinine) was found in 13% of the hypertensive patients considered, but only 4% of them knew this alteration. Left Ventricular Hypertrophy (LHV) was defined as LV mass index > 95 g/m for women and >115 g/ m for men. LVH was found in 39% of the hypertensive individuals but only 14% were aware. Carotid vascular hypertrophy and atherosclerosis was defined as IMT > 0.9mm and/or the presence of plaques. These alterations were found in 45% of the patients but only a minority of them (14%) was aware. In conclusion, our survey indicates that, in a selected population of 1320 mild-to-severe hypertensive patients referred to a specialized hypertension clinic, the awareness of asymptomatic organ damage is still low. Many patients, despite the thorough instrumental investigations performed in a specialized setting, seems not sufficiently informed on the normalcy threshold and/or tend to underestimate pathological findings.