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. 2023 Dec 20:10:1295174.
doi: 10.3389/fcvm.2023.1295174. eCollection 2023.

Clinical characteristics, treatment, and blood pressure control in patients with hypertension seen by primary care physicians in Spain: the IBERICAN study

Miguel A Prieto-Díaz  1   2 , Vicente Pallares-Carratala  3   4 , Rafael Manuel Micó-Pérez  5 , Carlos Escobar-Cervantes  6 , Vicente Martín-Sanchez  7 , Antonio Coca  8 , Alfonso Barquilla-García  9 , Sonsoles M Velilla-Zancada  10 , José Polo-García  11 , Antonio Segura-Fragoso  12 , Leovigildo Ginel-Mendoza  13 , Álvaro Hermida-Ameijerias  14 , Sergio Cinza-Sanjurjo  15   16 ; Investigators of the IBERICAN study and of the Spanish Society of Primary Care Physicians SEMERGEN Foundation
Affiliations

Clinical characteristics, treatment, and blood pressure control in patients with hypertension seen by primary care physicians in Spain: the IBERICAN study

Miguel A Prieto-Díaz et al. Front Cardiovasc Med. .

Abstract

Objectives: To determine the clinical profile, according to the history of hypertension, the risk of developing hypertension, current antihypertensive treatment and BP control rates in patients with hypertension from the IBERICAN cohort.

Methods: IBERICAN is an ongoing prospective cohort study, whose primary objective is to determine the frequency, incidence, and distribution of CVRF in the adult Spanish population seen in primary care settings. This analysis shows the baseline clinical characteristics of patients with hypertension. Adequate BP control was defined as BP <140/90 mmHg according to 2013 ESH/ESC guidelines.

Results: A total of 8,066 patients were consecutively included, of whom 3,860 (48.0%) had hypertension. These patients were older (65.8 ± 10.9 vs. 51.6 ± 14.7 years; p < 0.001), had more cardiovascular risk factors, target organ damage and cardiovascular disease (CVD) in comparison with those without hypertension. The risk of hypertension increased with the presence of associated CV risk factors and comorbidities, particularly diabetes, obesity and the metabolic syndrome, and decreased with the intensity of physical activity. Regarding antihypertensive treatments, 6.1% of patients did not take any medication, 38.8% were taking one antihypertensive drug, 35.5% two drugs, and 19.6% three or more antihypertensive drugs. Overall, 58.3% achieved BP goals <140/90 mmHg. A greater probability of BP control was observed with increasing age of patients and the greater number of antihypertensive drugs. Blood pressure control was lower in hypertensive patients with diabetes, obesity, the metabolic syndrome, increased urinary albumin excretion, higher pulse pressure, and lack of antihypertensive treatment.

Conclusions: About half of patients attended in primary care settings have hypertension in Spain. Patients with hypertension have a worse CV clinical profile than non-hypertensive patients, with greater association of CVRF and CVD. Around four out of ten patients do not achieve the recommended BP goals, and higher use of combination therapies is associated with a better BP control.

Keywords: blood pressure; cardiovascular risk; combined therapy; hypertension; primary care.

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Conflict of interest statement

The SEMERGEN Foundation has received grants from Astra Zeneca and Menarini, but none of these grants were dedicated to financing any article of the IBERICAN study, including this article. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Variables associated to blood pressure control in hypertensive patients*. *Multivariate logistic regression, stepwise backward method (LR). CI, Confidence interval; Number of antihypertensive drugs; Age; Obesity; Diabetes; Metabolic syndrome; Urinary albumin excretion (30–299 mg/g); None antihypertensive treatment; Pulse pressure >60 mmHg (≥65 years).
See this image and copyright information in PMC

References

    1. Brouwers S, Sudano I, Kokubo Y, Sulaica EM. Arterial hypertension. Lancet. (2021) 398:249–61. 10.1016/S0140-6736(21)00221-X - DOI - PubMed
    1. Blood Pressure Lowering Treatment Trialists’ Collaboration. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. Lancet. (2021) 397:1625–36. 10.1016/S0140-6736(21)00590-0 - DOI - PMC - PubMed
    1. Blood Pressure Lowering Treatment Trialists’ Collaboration. Age-stratified and blood-pressure-stratified effects of blood-pressure-lowering pharmacotherapy for the prevention of cardiovascular disease and death: an individual participant-level data meta-analysis. Lancet. (2021) 398:1053–64. 10.1016/S0140-6736(21)01921-8 - DOI - PMC - PubMed
    1. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. (2021) 398:957–80. 10.1016/S0140-6736(21)01330-1 - DOI - PMC - PubMed
    1. NCD Risk Factor Collaboration (NCD-RisC). Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys. Lancet. (2019) 394(10199):639–51. 10.1016/S0140-6736(19)31145-6 - DOI - PMC - PubMed

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