Hypertension prevalence, awareness, control and association with metabolic abnormalities in the San Marino population: the SMOOTH study

Mancia, Giuseppe; Parati, Gianfranco; Borghi, Claudio; Ghironzi, Giuseppe; Andriani, E; Marinelli, Liano; Valentini, Mariaconsuelo; Tessari, F.; Ambrosioni, Ettore

doi:10.1097/01.hjh.0000222752.67572.61

Cited by 74 publications

(56 citation statements)

References 39 publications

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“…15 Other European and American studies have similarly reported that around 25% of all hypertensives and 50% of treated patients have controlled blood pressure, [15][16][17] although further European studies have suggested that these figures may overestimate rates of control. [18][19][20][21] In South Africa, only 14% of hypertensives had adequately controlled blood pressure. 22 This gap between our ability to prevent and treat hypertension and the actual levels of control achieved constitutes a significant failing of public health management and health care worldwide.…”

Section: Introductionmentioning

confidence: 99%

Achieving blood pressure goals globally: five core actions for health-care professionals. A worldwide call to action

et al. 2007

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Section: Introductionmentioning

confidence: 99%

Achieving blood pressure goals globally: five core actions for health-care professionals. A worldwide call to action

et al. 2007

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“…Studies in both Europe and the United States have reported that only around 25% of all hypertensives and 50% of treated patients have controlled blood pressure, [4][5][6][7] while further European studies have suggested that true rates of control may be significantly lower. [8][9][10] The reasons for poor blood pressure control rates are complex. In part, they reflect the impact of structural and economic factors on access to health care, but local clinical, prescriber and patient factors that undermine the adequacy of treatment are also significant.…”

Section: Introductionmentioning

confidence: 99%

A comparison of the efficacy and safety of irbesartan/HCTZ combination therapy with irbesartan and HCTZ monotherapy in the treatment of moderate hypertension

et al. 2007

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This prospective, double-blind, parallel-group study randomized patients with moderate hypertension (seated systolic blood pressure (SeSBP) 160-179 mm Hg when seated diastolic blood pressure (SeDBP) o110 mm Hg; or SeDBP 100-109 mm Hg when SeSBP o180 mm Hg) 3:1:1 to treatment with irbesartan 300 mg/hydrochlorothiazide (HCTZ) 25 mg combination therapy (n ¼ 328), irbesartan 300 mg monotherapy (n ¼ 106) or HCTZ monotherapy 25 mg (n ¼ 104). Treatment was initiated at half dose, with forced titration to full dose after two weeks followed by ten further weeks' treatment. The primary efficacy variable was the mean reduction in SeSBP from baseline to week 8. Baseline characteristics were similar between groups, with mean baseline blood pressure approximately 162/98 mm Hg; the mean age was 55 years. At week 8 there was a reduction in SeSBP of 27.1 mm Hg with irbesartan/HCTZ, compared with 22.1 mm Hg with irbesartan monotherapy (P ¼ 0.0016) and 15.7 mm Hg with HCTZ (Po0.0001). Both the rate of decline and the total degree of decline achieved were greatest with irbesartan/ HCTZ and least with HCTZ. A significantly greater percentage of patients reached a treatment goal of SeSBP o140 mm Hg and SeDBP o90 mm Hg by week 8 with irbesartan/HCTZ (53.4%), compared with irbesartan (40.6%; P ¼ 0.0254) and HCTZ (20.2%; Po0.0001) alone. Treatment was well tolerated in all three-treatment groups with a slight increase in adverse events in the combination therapy group. In conclusion, irbesartan/HCTZ (300/25 mg) is well tolerated and achieves rapid and sustained reductions in both systolic blood pressure and diastolic blood pressure in patients with moderate hypertension.

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“…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.…”

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Achievement of Cardiometabolic Goals in Aware Hypertensive Patients in Spain

et al. 2012

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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...

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Hypertension prevalence, awareness, control and association with metabolic abnormalities in the San Marino population: the SMOOTH study

Abstract: Even in a small Mediterranean country with high health-care standards, hypertension awareness, treatment and control are inadequate and hypertension clusters with metabolic abnormalities and risk factors as in non-Mediterranean areas.

Cited by 74 publications

References 39 publications

Achieving blood pressure goals globally: five core actions for health-care professionals. A worldwide call to action

Achieving blood pressure goals globally: five core actions for health-care professionals. A worldwide call to action

A comparison of the efficacy and safety of irbesartan/HCTZ combination therapy with irbesartan and HCTZ monotherapy in the treatment of moderate hypertension

Achievement of Cardiometabolic Goals in Aware Hypertensive Patients in Spain

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