Background Interventions to improve blood pressure (BP) control in hypertension have had limited success in clinical practise despite evidence of cardiovascular disease prevention in randomised controlled trials.
Purpose To evaluate BP control and patterns of antihypertensive pharmacotherapy in a population in the Central Region of Portugal, attending a hospital outpatient clinic for routine follow-up.
Materials and Methods Medical data of adult (age range, 18 to 85 years) hypertensive patients attending the hypertension clinic of Hospital Centre of Cova da Beira, Covilhã, Portugal, from March to August 2012, were prospectively obtained from medical records and analysed. Demographic variables, clinical data and BP values of hypertensive patients included in the study, as well as prescribing metrics, were examined on a descriptive basis and expressed as the mean±SD, frequency and percentages. Student’s test and Mann-Whitney rank sum test were used to compare continuous variables and the χ2 test and Fisher exact probability test were used to test for differences between variables in different categories.
Results In all, 47% of hypertensive patients (n = 44) had their BP controlled according to international guidelines. About 54% of patients with a target BP < 140/90 mmHg (n = 74) were controlled, whereas in patients with diabetes and/or chronic kidney disease (n = 20) the corresponding figure was only 20% (P = 0.007). The angiotensin II-receptor antagonists were the most prescribed drugs (57.5%), followed by calcium channel blockers (55.3%) and β-blockers (42.5%). About 82.4% hypertensive patients with comorbid diabetes were treated with an angiotensin-converting enzyme inhibitor or an angiotensin II-receptor antagonist.
Conclusions Many hypertensive patients prescribed antihypertensive treatment fail to achieve BP control in clinical practise; this control being worse among patients with diabetes or chronic kidney disease. As prescribing patterns seem to conform to international guidelines, further research is needed to identify the causes of poor BP control.
No conflict of interest.
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