Blood pressure levels and control in Italy: comprehensive analysis of clinical data from 2000–2005 and 2005–2011 hypertension surveys

Abstract

This analysis is aimed to determine blood pressure (BP) levels and BP control rates in a large population of hypertensive patients in Italy. Data were taken from two large and inclusive cross-sectional surveys, which covered two distinct and subsequent time periods (2000-2005 and 2005-2011, respectively). Observational clinical studies and surveys, which reported average systolic/diastolic clinic BP levels, proportions of treated/untreated and controlled/uncontrolled patients, and prevalence of cardiovascular risk factors in hypertensive patients followed in either outpatient clinics, hypertension centres or general practice, were considered for the analyses. The overall sample included 211 591 hypertensive patients (119 997 (56.7%) women, age 57.0±10.0 years, body mass index 26.9±4.0 kg m(-2), BP levels 146.9±16.7/88.7±9.6 mm Hg). BP levels were 148.2±15.4/87.5±9.3 mm Hg in patients followed by general practitioners (n=168 313, 79.5%), 148.1±17.3/90.1±9.7 mm Hg in those followed by hypertension centres (n=28 180, 13.3%), and 142.4±17.6/86.6±9.8 mm Hg in those followed by outpatient clinics and hospital divisions (n=15 098, 7.1%). Among treated hypertensive patients (n=128 079; 60.5%), 43 008 (33.6%) were reported to have controlled BP levels. Over one decade of observation, we reported that ~60% of hypertensive patients were treated and among these only 33% achieved effective BP control. These findings highlight the need for more effective interventions to improve management of hypertension in Italy.

Trends in Hypertension Control Among the Older Population of Spain From 2000 to 2001 to 2008 to 2010

“…2,4,5,7 Several studies have shown that in some countries the prevalence of hypertension has been generally stable and that a significant improvement in hypertension management has occurred during the past few decades. [8][9][10][11][12][13][14][15] However, some studies have found no recent progress in BP control, 16,17 and it has been questioned whether a favorable trend is actually occurring in the population. 18 Discrepancies in results among studies might be partly because of the use of different settings and procedures for BP measurement.…”

Lack of Blood Pressure Control in Italy: Room for Improvement?

“…Despite a solid and undisputable evidence of the efficacy of antihypertensive treatment in cardiovascular prevention, the awareness, treatment and control of elevated BP values are still low in most industrialized countries, including Italy [3][4][5][6][7][8]. Poor BP control rates have been reported also by large observational studies and clinical surveys, performed in different clinical settings and in different countries.…”

“…Poor BP control rates have been reported also by large observational studies and clinical surveys, performed in different clinical settings and in different countries. The lack of BP control translates in a significant increase in the incidence of stroke, coronary artery disease, heart failure and chronic kidney disease.Recent data collected in several European countries and in Italy have shown that among treated patients only about 30 % reach an adequate BP control [3][4][5][6][7][8]. In Italy it has been documented that in years between 2005 and 2011 only 60 % of subjects with high BP are treated and among them the reduction of BP below 140/90 mHg is observed in 37 %.…”

“…Recent data collected in several European countries and in Italy have shown that among treated patients only about 30 % reach an adequate BP control [3][4][5][6][7][8]. In Italy it has been documented that in years between 2005 and 2011 only 60 % of subjects with high BP are treated and among them the reduction of BP below 140/90 mHg is observed in 37 %.…”

“…This increase is mainly the consequence of aging and of unfavourable lifestyle changes in developing countries, characterized by a growing incidence of obesity, smoking habits, sedentary life and salt consumption. In the United States arterial hypertension accounts for 40 million office visits per year and for more than $93 billion in total costs [2].Despite a solid and undisputable evidence of the efficacy of antihypertensive treatment in cardiovascular prevention, the awareness, treatment and control of elevated BP values are still low in most industrialized countries, including Italy [3][4][5][6][7][8]. Poor BP control rates have been reported also by large observational studies and clinical surveys, performed in different clinical settings and in different countries.…”