Blood pressure control in a hypertension hospital clinic
作者:
Cesare Cuspidi,
Laura Lonati,
Lorena Sampieri,
Giuseppe Macca,
Laura Valagussa,
Tiziana Zaro,
Iassen Michev,
Maurizio Salerno,
Gastone Leonetti,
Alberto Zanchetti,
期刊:
Journal of Hypertension
(OVID Available online 1999)
卷期:
Volume 17,
issue 6
页码: 835-841
ISSN:0263-6352
年代: 1999
出版商: OVID
关键词: anti-hypertensive treatment;blood pressure control;hypertension;left ventricular hypertrophy
数据来源: OVID
摘要:
ObjectivesFirst, to evaluate the prevalence of clinic blood pressure (BP) control (BP ≤ 140/90 mmHg) in a representative sample of treated hypertensive patients followed in our hypertension clinic. Second, to assess in a subgroup of these patients: (a) the proportion of BP control with both clinic blood pressure (CBP ≤ 140/90 mmHg) and daytime ambulatory blood pressure (ABP) (≤ 132/85 mmHg) criteria, and (b) the prevalence of echocardiographic left ventricular hypertrophy (LVH) (left ventricular mass index, LVMI > 125 g/m2in men and > 110 g/m2in women).Design and methodsSeven hundred consecutive hypertensive patients who attended our hypertension centre clinic during a period of 6 months and who had regularly been followed up by the same medical team were included in the study. BP was taken in the clinic by a doctor using a mercury sphygmomanometer with the participants seated. Seventy-four patients with similar demographic and clinical characteristics to the entire population of participants underwent complete echocardiographic examination and 24 h ABP monitoring.ResultsDuring follow-up, 352 of the treated patients had clinic BP ≤ 140/90 mmHg, 198 ≤ 160/95 mmHg and 150 > 160/95 mmHg, indicating that BP control was satisfactory in 50.3%, borderline in 28.3% and unsatisfactory in 21.4% of the cases. In the subgroup of 74 patients, the proportion of individuals with satisfactory clinic BP control (CBP ≤ 140/90 mmHg) was higher (50.0 versus 33.6%) than with satisfactory ABP control (daytime ABP values ≤ 132/85 mmHg). LVH was found in 21 of the 74 patients (28.3%): 12 of them had unsatisfactory CBP control and 19 had unsatisfactory ABP control. LVMI did not correlate with CBP values but only with ABP values (mean 24 h systolicr= 0.47, diastolicr= 0.40,P< 0.001; mean daytime systolicr= 0.45, mean daytime diastolicr= 0.39,P< 0.001; mean night-time systolicr= 0.38, mean night-time diastolicr= 0.38,P< 0.001).ConclusionThis study demonstrates that hypertensive patients managed in a hypertension centre clinic have satisfactory CBP control in 50% of cases, but this rate seems to over-estimate the effective BP control during daily life. A large fraction of patients show persistence of LVH and this evidence of organ damage almost entirely concerns individuals with poor ABP control.
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