Lack of control of hypertension in primary cardiovascular disease prevention in Europe: Results from the EURIKA study

      Highlights

      • EURIKA was a cross-sectional observational study in 12 European countries.
      • Uncontrolled hypertension was assessed among patients treated for hypertension.
      • More than half of all treated patients continued to have uncontrolled hypertension.
      • Approximately 14% had apparent resistant hypertension.
      • Associations were seen between hypertension and other cardiovascular risk factors.

      Abstract

      Background

      The prevalence of and factors associated with uncontrolled hypertension and apparent resistant hypertension were assessed in the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; NCT00882336).

      Methods

      EURIKA was a cross-sectional observational study including patients being treated for the primary prevention of cardiovascular disease in 12 European countries. Patients were assessed if they were being treated for hypertension (N = 5220). Blood pressure control was defined according to European guidelines, with sensitivity analysis taking account of patients' age and diabetes status. Associated factors were assessed using multivariate analysis.

      Results

      In the primary analysis, a total of 2691 patients (51.6%) had uncontrolled hypertension. Factors significantly associated with an increased risk of having uncontrolled hypertension included female sex (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.93–2.73), body mass index (BMI; OR per kg/m2: 1.03; 95% CI: 1.01–1.04), and geographic location. A total of 749 patients (14.3%) had apparent resistant hypertension. Factors significantly associated with an increased risk of having apparent resistant hypertension included BMI (OR per kg/m2: 1.06; 95% CI: 1.04–1.08), diabetes (OR: 1.28; 95% CI: 1.06–1.53), use of statins (OR: 1.36; 95% CI: 1.15–1.62), serum uric acid levels (OR: 1.16; 95% CI: 1.09–1.23), and geographic location. Similar results were seen in sensitivity analyses.

      Conclusions

      Over 50% of patients treated for hypertension continued to have uncontrolled blood pressure and 14.3% had apparent resistant hypertension. Positive associations were seen with other cardiovascular risk factors.

      Abbreviations:

      ACE (angiotensin-converting enzyme), BMI (body mass index), CI (confidence interval), CVD (cardiovascular disease), DBP (diastolic blood pressure), ESC (European Society of Cardiology), ESH (European Society of Hypertension), EURIKA (European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice), HbA1c (glycated haemoglobin), HDL-C (high-density lipoprotein cholesterol), LDL-C (low-density lipoprotein cholesterol), OR (odds ratio), SCORE (Systematic Coronary Risk Evaluation), SBP (systolic blood pressure), SD (standard deviation)

      Keywords

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