PP.30.13

Abstract

Objective: Cardiovascular (CV) risk stratification in patients with arterial hypertension is essential for tailoring adequate antihypertensive treatment. Only few data is available on CV risk stratification in primary care patients with arterial hypertension. The aim of this subanalysis from the Swiss Hypertension Cohort Study (HccH) was to evaluate the compliance of general practitioners with the ESH/ESC guidelines on CV risk stratification in arterial hypertension as well as potential gaps in the risk stratification process. Design and method: HccH is an ongoing prospective observational study which has been initiated in 2005 by the Institute for Primary Care of the University of Basel, Switzerland. Data collection is conducted by general practitioners in Switzerland. Eligible patients are adult men and women (age > = 18 years) with arterial hypertension. Inclusion criteria are antihypertensive treatment respectively a mean through sitting office blood pressure (OBPM) > = 140/90mmHg. Patient characteristics, OBPM, ambulatory blood pressure (ABPM), CV risk factors, asymptomatic target organ damage (OD), diabetes mellitus (DM), chronic kidney disease (CKD) and symptomatic CV and renal disease are recorded on an annual basis and CV risk analyzed according to the 2013 ESH/ESC Guidelines. Results: Baseline data from 1005 patients included into HccH are given in the following table:BMI: Body Mass Index; CHD: Coronary Heart Disease; CHF: Congestive Heart Failure; CKD: Chronic Kidney Disease; GFR: Glomerular Filtration Rate; PAD: Peripheral Artery Disease; TIA: Transitory Ischemic Attack; Smoking Status: Y: active smoker, N: never smoked, Ex: former smoker. Data given as mean ± SD or absolute numbers (% of recorded data) where applicable. Conclusions: Decisions about treatment and optimal therapy in hypertensive patients should be based on an individual overall CV risk. Therefore a complete performance of risk stratification is very important. Our preliminary analysis from HccH demonstrates that CV risk factors from medical history and clinical data, with the exception of ABPM, appear to be comprehensively recorded in primary care. Substantial gaps were revealed with regards to the assessment of asymptomatic OD, particularly microalbuminuria and left ventricular hypertrophy, indicating that overall CV risk may be significantly underestimated in primary care patients with arterial hypertension.