These data suggest that cognitive-emotional hyperarousal may be a premorbid characteristic of subjects vulnerable to insomnia. It seems that maladaptive coping stress strategies and cognitive-emotional hyperarousal predispose to the development of insomnia and that interventions targeting these characteristics may be important in the prevention and treatment of chronic insomnia.

Hypertension is a major public health problem in elderly Spaniards. Most hypertensives had their hypertension uncontrolled. Greater emphasis should be laid on the most disadvantaged (the older, men, and those with lowest education) in terms of hypertension management, and on reinforcing weight loss and combining drugs for enhanced hypertension control.

No abstract

H ypertension accounts for a substantial portion of cardiovascular disease (CVD) and mortality in the general population.1,2 However, the mortality gap between adults with and without hypertension has remained relatively constant over time in some countries.2 Consequently, efforts are needed to accelerate the decrease in the mortality rate among hypertensive adults.In this vein, clinical guidelines on hypertension management not only focus on blood pressure (BP) but have also proposed lifestyle and treatment targets for associated CVD risk factors.3,4 Some organizations are also launching multifaceted interventions on health factors and behaviors to reduce the burden of CVD. 5,6 However, the achievement of targets for CVD risk factors associated with hypertension 7,8 has been studied much less than the control of hypertension itself. 9-11 Previous research focused on only a few additional risk factors screened in primary care clinics, 7 generally lipids and glucose profile, or reported the association of BP control with lifestyle and some metabolic abnormalities in clinical settings. 8,[12][13][14][15] Lastly, little is known as to whether the diagnosis of hypertension is related to the degree of attainment of cardiometabolic goals.In this study, we examined the nationwide degree of awareness of hypertension in the adult population of Spain and the achievement of cardiometabolic goals according to awareness of the hypertensive condition of the individuals. We also presented the prevalence and control of all hypertensive patients. To our knowledge, no previous study has reported a comprehensive assessment of the attainment of Abstract-Despite the importance of achieving cardiometabolic goals beyond blood pressure, in the health of hypertensives, no comprehensive assessment of these characteristics has been performed in whole countries. We studied in 2008-2010 a total of 11 957 individuals representative of the Spanish population aged ≥18 years. Information on cardiometabolic characteristics was collected at the participants' homes, through structured questionnaires, physical examination, and fasting blood samples. A total of 3983 individuals (33.3%) had hypertension (≥140/90 mm Hg or current antihypertensive drug treatment), 59.4% were aware of their condition, 78.8% treated among those aware, and 48.5% controlled among those aware and treated (22.7% of all hypertensives). Of the aware hypertensives, 13.8% had a body mass index <25 kg/m 2 , 38.6% consumed <2.4 g/d of sodium, 19.3% were diabetic with 61% attaining goal hemoglobin A1c <6.5%, whereas 42.3% had hypercholesterolemia, with 38.1% reaching goal low-density lipoprotein <115 mg/dL. Only 30.7% of overweight patients received a prescription of specific method for weight loss, 17.4% of daily smokers were offered a smoking cessation strategy, and 15.8% of older patients were given a flu shot. Aware and unaware hypertensives showed a similar frequency of some lifestyle, such as adequate physical activity. In conclusion, in a European country with a well-develop...