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Gianluca Tomassoni, Maria Contina Marinucci, Pier Giorgio Masci, Maria Scatigna, Giovambattista Desideri, Claudio Ferri, Anna Santucci, P-487: Blood pressure control in Italy, American Journal of Hypertension, Volume 14, Issue S1, April 2001, Page 194A, https://doi.org/10.1016/S0895-7061(01)01701-0
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Abstract
Although hypertension is one of the most important cardiovascular risk factor in western societies, the outcomes of achieving blood pressure normalisation in european countries are still disappointing. During the current year, 1554 consecutive hypertensive patients referred to our Hypertension Outpatient Unit for obtaining a “certificate of disease”. Among the above patients, we selected those [n=214 (13.7%); 134 females, 80 males; mean age 64±11 years) whose hypertension was managed by general practitioners since the first diagnosis. Data were collected by accurate personal history, clinical documents, and the use of a questionnaire. Initial blood pressure levels, i.e. pre-treatment, resulted of 178±19/102±11 mmHg. Post-treatment blood pressure (mean hypertension duration = 10±8 years) was 149±15/87±8 mmHg (p<0.0001). Most patients (43.9%) were treated with one drug, while 33.2% with two, 15.9% with three and 0.5% with four or more antihypertensive drugs. A non-pharmacological treatment (6 months or more) preceded drug prescription only in 14 patients (6.5%). Either detailed oral or written instructions on lifestyle modifications were given to only 16.3% of the whole hypertensive population, in spite 54% of the cases manifested a low cardiovascular risk at the time of hypertension diagnosis. A systolic/diastolic blood pressure <140/90 mmHg was achieved by 23/214 patients (10.7%). Among these latter patients, 10 received one and 13 two or more antihypertensive drugs. A systolic/diastolic blood pressure that was comprised between 140/90 mmHg and 160/95 mmHg was achieved by 74 patients (34,6%), 22 of whom were treated by a single drug regimen. An unsatisfactory systolic/diastolic blood pressure control (i.e. systolic/diastolic blood pressure levels > 160/95 mmHg) was observed in 26 patients (12.1%), 8 of whom were in monotherapy. The remaining patients (n=91, 42.5%) manifested either a diastolic blood pressure > 95 mmHg with a systolic blood pressure < 140 mmHg or a systolic blood pressure > 160 mmHg with a diastolic blood pressure < 90 mmHg. Thus, 89.3% of treated hypertensive patients managed by general practitioners is still hypertensive in Italy. Statistical analysis failed to indicate an interpretation of such delusive results, but poor attention to lifestyle changes should be taken into consideration.
