The COMmon control of hypErtenSion and Therapeutic Attitudes in Belgium and Luxemburg study (COME STAI)

Abstract

Study aim: The aim of this study was to assess hypertension management in general practice in Belgium and Luxembourg, shortly before the publication of the 2013 ESH/ESC Guidelines for arterial hypertension management.

Methods: A total of 516 general physicians evaluated 10,078 consecutive hypertensive patients. All used the same definitions to assess cardiovascular risk.

Results: Systolic (S) blood pressure (BP) was 139 ± 19 mmHg, diastolic (D) BP 80 ± 11 mmHg, patients were 64 ± 13 years old and their body mass index (BMI) was 28 ± 5 kg/m2 (mean ± SD). Treatment remained unchanged in 71% of the patients with a SBP ≥ 140 mmHg. Those on ≥ 2 antihypertensive drugs were older, had higher BMI, slower HR, higher perceived cardiovascular risk, but lower BP (all P ≤ 0.001 vs no and monotherapy groups). Patients in whom treatment was intensified were at higher cardiovascular risk, as substantiated by an increased prevalence of males, a higher BP, a faster HR and a larger BMI (all P ≤ 0.0001). High cardiovascular risk patients underwent more frequent treatment simplifications with fixed-combination therapies or the addition of another antihypertensive class (all P ≤ 0.0001 vs not at high cardiovascular risk). Among the 523 patients older than 80 years with SBP ≥ 140 mmHg, treatment intensification occurred in 32% when SBP ≥ 150 mmHg, and in 10% when SBP was between 140 and 149 mmHg (P ≤ 0.0001).

Conclusion: The COME STAI study suggests that there is still room for improvement in hypertension control in Belgium and Luxembourg.

Keywords: Hypertension | general practice | ageing | Belgium | Luxembourg.