Prevalence and determinants of undertreatment of hypertension in the Netherlands

Schelleman, Hedi; Klungel, Olaf H.; Kromhout, Daan; Boer, Anthonius de; Stricker, Bruno H.; Verschuren, W. M. Monique

doi:10.1038/sj.jhh.1001672

Cited by 40 publications

(36 citation statements)

References 37 publications

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“…However, only one in every five patients received an add-on therapy in the first year of treatment. This confirms the findings from previous studies showing that hypertension is undertreated in The Netherlands [23,24]. Moreover, 30% of all newly treated patients discontinued treatment in the first year, which is similar to results from other studies [15][16][17].…”

Section: Discussionsupporting

confidence: 82%

Uptake of angiotensin II receptor blockers in the treatment of hypertension

Greving

Denig

Veen

et al. 2005

Eur J Clin Pharmacol

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Section: Discussionsupporting

confidence: 82%

Uptake of angiotensin II receptor blockers in the treatment of hypertension

Greving

Denig

Veen

et al. 2005

Eur J Clin Pharmacol

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“…15 The prevalence of 17% hypertension in our study is markedly higher than the 3.7% prevalence of hypertension in the general population of Dutch women between 30 and 39 years. 16 Adding the excluded women who remained hypertensive after the preeclamptic index pregnancy (47/386; 12%)) the overall prevalence of hypertension after preeclampsia is comparable with the mean prevalence of 30% to 40% found in other studies in formerly preeclampsia women. 6,[17][18][19][20] Our data show that a substantial proportion of women progressed within a few years from normotension to hypertension.…”

Section: Discussionsupporting

confidence: 63%

Low Plasma Volume in Normotensive Formerly Preeclamptic Women Predisposes to Hypertension

et al. 2015

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P reeclampsia is a serious hypertensive pregnancy disorder complicating 2% to 5% of all pregnancies. Preeclampsia is characterized by hypertension and proteinuria after 20 weeks of gestation. Women with a history of preeclampsia are at increased risk to develop early onset cardiovascular disease (CVD) later in life when compared with women who had an uneventful pregnancy.1 Therefore, in 2011, the American Heart Association added preeclampsia to the list of risk factors for developing CVD.2 The mechanistic explanation for the link between preeclampsia and later CVD remains to be elucidated. 3Numerous studies demonstrated increased prevalence of cardiovascular risk factors after a pregnancy complicated by preeclampsia. [4][5][6] Most formerly preeclampsia women, however, do not demonstrate a traditional cardiovascular risk profile within the first years after preeclampsia.6 Yet, when compared with healthy parous controls, the relative risk of developing chronic hypertension within 15 years after preeclampsia is estimated 3.7 (95% confidence interval, 2.7-5.5).1 This observation indicates that a subset of normotensive formerly preeclampsia women is at risk to develop hypertension within the first years after the affected pregnancy. It is conceivable that these formerly preeclampsia women have subtle or latent abnormalities that could explain the increased cardiovascular risk after pregnancy.Low plasma volume (PV) is considered to reflect latent hypertension, 7 and normotensive formerly preeclampsia women with low PV (LPV) are prone to develop recurrent hypertensive disease in subsequent pregnancy. 8 Whether PV status also relates to chronic hypertension after a pregnancy complicated by preeclampsia has never been studied before. We hypothesized that LPV status in normotensive formerly preeclampsia women predisposes to the development of hypertension. In this longitudinal study, we additionally studied how the traditional cardiovascular and metabolic risk profiles evolve over time after a preeclamptic pregnancy.Abstract-Formerly preeclamptic women are at risk for cardiovascular disease. Low plasma volume may reflect latent hypertension and potentially links preeclampsia with chronic cardiovascular disease. We hypothesized that low plasma volume in normotensive formerly preeclamptic women predisposes to hypertension. We longitudinally studied n=104 formerly preeclamptic women in whom plasma volume was measured 3 to 30 months after the preeclamptic pregnancy. Cardiovascular variables were assessed at 2 points in time (3-30 months postpartum and 2-5 years thereafter). Study population was divided into low plasma volume (≤1373 mL/m 2 ) and normal plasma volume (>1373 mL/m 2 ). Primary end point was hypertension at the second visit: defined as ≥140 mm Hg systolic or ≥90 mm Hg diastolic. Secondary outcome of this study was change in traditional cardiovascular risk profile between visits. Variables correlating univariately with change in blood pressure between visits were introduced in regression analysis. Eighteen of 104 ...

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“…The primary outcome was the odds of the occurrence of hypertension in idiopathic hyperCKemia, compared to population controls. Hypertension was defined as current systolic pressure ≥ 140 mm Hg, or diastolic pressure ≥ 90 mm Hg, both without established cause (primary hypertension), or the use of antihypertensive medication for primary hypertension, according to international guidelines [12,15,22]. Sample size calculations for the primary outcome measure were based on the assumption that hypertension occurs twice as often with hyperCKemia as in the general population [5,8].…”

Section: ■ Study Population and Clinical Studiesmentioning

confidence: 99%

Hypertension risk in idiopathic hyperCKemia

et al. 2008

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Patients with idiopathic hyperCKemia are usually reassured and discharged. However, these subjects may have increased hypertension risk, based on data from our population study, which showed that the population tertile with the highest serum creatine kinase activities had the highest systolic and diastolic blood pressure levels. Therefore, we assessed whether subjects with idiopathic hyperCKemia have greater occurrence of hypertension than controls. We included 46 participants aged 18 to 67 years, diagnosed with idiopathic hyperCKemia at the departments of Neurology of the Universities of Amsterdam and Utrecht, The Netherlands. We found that 48% of the subjects with idiopathic hyperCKemia were hypertensive, as compared to 19% of the random population controls (n = 22,612, aged 20 to 65 years), an odds ratio of 3.9 (95 % CI, 2.2 to 6.9) before, and 2.0 (1.1 to 3.8) after adjustment for sex, age, and body mass index. In accord with our previous finding of an association between creatine kinase and blood pressure in the general population, the data reported here suggest that subjects with idiopathic hyperCKemia have greater hypertension risk than controls. This may be due to relatively high tissue creatine kinase activity, resulting in greater ATP buffer capacity to create and sustain high blood pressure levels.Larger, prospective studies are needed to further assess this association, but as active case finding is important in the diagnosis of hypertension, subjects with idiopathic hyperCKemia should be screened and monitored for the presence of hypertension.

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Prevalence and determinants of undertreatment of hypertension in the Netherlands

Cited by 40 publications

References 37 publications

Uptake of angiotensin II receptor blockers in the treatment of hypertension

Uptake of angiotensin II receptor blockers in the treatment of hypertension

Low Plasma Volume in Normotensive Formerly Preeclamptic Women Predisposes to Hypertension

Hypertension risk in idiopathic hyperCKemia

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