Document Detail


Blood pressure is insufficiently controlled in European patients with established coronary heart disease.
MedLine Citation:
PMID:  14508188     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Elevated blood pressure is associated with an impaired prognosis in patients with established coronary heart disease. Adequate blood pressure control is therefore of utmost importance. We report on two successive European surveys that evaluated whether the goals given in recommendations on secondary prevention are achieved. METHODS: The first European Action on Secondary Prevention through Intervention to Reduce Events (EUROASPIRE I) survey was conducted during 1995-1996 in 21 hospitals in nine European countries. The second survey (EUROASPIRE II) was conducted during 1999-2000 in 47 hospitals (including 20 hospitals that participated in EUROASPIRE I) in 15 Europeans countries. Consecutive patients (aged < 71 years) were identified from hospital records after coronary artery bypass grafting, percutaneous coronary intervention, myocardial infarction, or myocardial ischaemia. Patients were invited for an interview and examination at least 6 months after hospitalization. During the interview, blood pressure was measured in a standardized fashion. Systolic blood pressure >/= 140 mmHg and/or a diastolic blood pressure >/= 90 mmHg were considered as elevated blood pressure. EUROASPIRE II provides a more comprehensive view on the actual management of patients with established coronary disease. Therefore, we decided to concentrate mainly on the EUROASPIRE II data, and to use EUROASPIRE I for the evaluation of time trends. RESULTS: In EUROASPIRE II, 5556 patients were interviewed, and 51% were diagnosed with elevated blood pressure. Large regional variations in the prevalence of elevated blood pressure were observed, with values ranging from 37 to 64%. Twenty-five per cent (1401) of patients were on a diet to reduce blood pressure, and among these 61% had elevated blood pressure. The prevalence of elevated blood pressure among the 4827 (87%) patients taking blood pressure-lowering medication (which was not necessarily taken as an antihypertensive treatment) was 51%. Patients with elevated blood pressure were more likely to be diabetic, hypercholesterolemic, and obese than normotensive patients. The proportion of patients who reported being aware of their hypertensive status was somewhat higher in EUROASPIRE II than in EUROASPIRE I (71 versus 67%), and the use of blood pressure-lowering medication was intensified (91 versus 85%). However, these changes were not accompanied by a decrease in the prevalence of elevated blood pressure (54 versus 55% in centres that participated in both surveys). CONCLUSION: During 1995-2000 the prevalence of elevated blood pressure in patients with established coronary heart disease remained at an unacceptably high level. Throughout Europe, still about half of coronary patients require more intensive blood pressure management.
Authors:
Eric Boersma; Ulrich Keil; Dirk De Bacquer; Guy De Backer; Kalevi Pyörälä; Don Poldermans; Cristiana Leprotti; Lorenza Pilotto; Esther de Swart; Jaap W Deckers; Jan Heidrich; Susana Sans; Kornelia Kotseva; David Wood; Giovanni B Ambrosio;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  21     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-09-25     Completed Date:  2004-06-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1831-40     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands. h.boersma@erasmusmc.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Antihypertensive Agents / therapeutic use*
Blood Pressure
Coronary Disease / epidemiology*,  prevention & control*
Data Collection
Europe / epidemiology
Female
Humans
Hypertension / drug therapy*,  epidemiology*
Male
Middle Aged
Physician's Practice Patterns / statistics & numerical data
Prevalence
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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