Blood pressure control in Italy: results of recent surveys on hypertension

BACKGROUNDBlood pressure (BP) control is reported to be poor in hypertensive patients worldwide. OBJECTIVEBP levels, the rate of BP control, prevalence of risk factors and total cardiovascular risk were assessed in a large cohort of hypertensive patients, derived from recent surveys performed in Italy. METHODSFifteen studies on hypertension, performed in different clinical settings (general population, general clinical practice, specialist outpatient clinics and hypertension centres) over the past decade were considered. RESULTSThe overall sample included 52 715 hypertensive patients (26 315 men and 26 410 women, mean age 57.3 ± 6.9 years). Despite the high percentage of patients on stable antihypertensive treatment (n = 36 556, 69%), mean systolic and diastolic BP levels were 147.8 ± 8.5 and 89.5 ± 5.2 mmHg, respectively. On the basis of the nature of the study (population surveys or clinical referrals), systolic BP levels were consistently higher than the normality threshold in both settings (142.6 ± 12.4/84.8 ± 3.7 mmHg and 150.4 ± 4.6/91.9 ± 4.1 mmHg, respectively). The BP stratification could be assessed in 40 829 individuals4.5% had optimal, 9.2% normal and 8.3% high-normal BP levels, however, the large majority were in grade 1 (39%) or grades 2–3 (32.6%) hypertension. In the overall sample, 55.9% of hypertensive patients had hypercholesterolemia, 28.7% were smokers, 36.4% were overweight or obese and 15.0% had diabetes mellitus. Cardiovascular risk stratification was assessed in 37 813 hypertensives23.2% had low, 33.9% moderate, 30.2% high and 12.7% very high added risk. CONCLUSIONOur analysis demonstrates the persistence of poor BP control and high prevalence of risk factors, supporting the need for more effective, comprehensive and urgent actions to improve the clinical management of hypertension.