Hypertension Control and Guideline-Recommended Target Blood Pressure Goal Achievement at an Early Stage of Hypertension in the UAE

Abstract

(1) Background: The present study aimed to assess the changes in blood pressure (BP) within the first 6 months of treatment initiation in a newly treated hypertensive cohort and to identify the factors that are associated with achieving the target BP recommended by the American (ACC/AHA, 2017), European (ESC/ESH, 2018), United Kingdom (NICE, 2019), and International Society of Hypertension (ISH, 2020) guidelines. (2) Methods: We analyzed 5308 incident hypertensive outpatients across Abu Dhabi, United Arab Emirates (UAE), in 2017; each patient was followed up for 6 months. Hypertension was defined as a BP of 130/80 mmHg according to the ACC/AHA guidelines and 140/90 mmHg according to the ESC/ESH, NICE, and ISH guidelines. Multiple logistic regression was used to identify factors associated with achieving the guideline-recommended BP targets. (3) Results: At baseline, the mean BP was 133.9 ± 72.9 mmHg and 132.7 ± 72.5 mmHg at 6 months. The guideline-recommended BP targets were 39.5%, 43%, 65.6%, and 40.8%, according to the ACC/AHA, ESC/ESH, NICE, and ISH guidelines, respectively. A BMI of <25 kg/m2 was associated with better BP control according to the ACC/AHA (odds ratio (OR) = 1.26; 95% confidence interval (CI) = 1.07–1.49), ESC/ESH (OR = 1.27; 95% CI = 1.08–1.50), and ISH guidelines (OR = 1.22; 95% CI = 1.03–1.44). Hypertension treated in secondary care settings was more likely to achieve the BP targets recommended by the ACC/AHA (1.31 times), ESC/ESH (1.32 times), NICE (1.41 times), and ISH (1.34 times) guidelines. (4) Conclusions: BP goal achievement was suboptimal. BP control efforts should prioritize improving cardiometabolic goals and lifestyle modifications.

Suboptimal Target Blood Pressure Control and Its Association With the Sociodemographic and Clinical Profiles of Hypertensives Attending a Tertiary Level Hospital in Addis Ababa, Ethiopia

“…The fact that there were more overweight and obese hypertensives in this study may indirectly explain why the BP control rate was low. Our finding is consistent with several previous studies [46][47][48].…”

Comorbid Psoriasis and Metabolic Syndrome: Clinical Implications and Optimal Management

“…20 aHT is defined as a blood pressure (BP) above 130/80 mmHg according to the ACC/AHA guidelines and 140/90 mmHg according to the ESC/ESH, NICE, and ISH guidelines. 21 Given that psoriasis patients have an inherently increased risk of developing aHT, dermatologists need to give special consideration to this comorbidity when following up and treating psoriasis patients. 16 …”

Low Cardiovascular Risk Reduction Behaviors Among Hypertensives Attending Follow-Up Care at a Tertiary-Level Hospital in Addis Ababa, Ethiopia

“…Even though studies on this topic have yielded few results, the frequency of clinic visits may be a reflection of patients with CVD's health-seeking behaviors, related to patients' perceptions that their BP and symptoms are under control, that clinic visits have been scheduled at regular intervals by doctors, or related to the COVID-19 pandemic season. According to the current HTN management guidelines (51), clinic visits every 2-4 months should be conducted for patients who have achieved the target BP control. However, only 14.1% of our study participants had every three months follow-ups visits, while nearly three-quarters (72.1%) of them, and in other studies, the majority of hypertensives (52,53) had the visit follow-up clinic scheduled monthly and/or bimonthly for HTN that may suggest patients were being monitored more closely to achieve BP control that required medication adjustment (based on patients' adherence and possible drug side effects) and evaluation of target organ disease and the co-existence of comorbid conditions.…”