Differences in Blood Pressure Control and Stroke Mortality Across Spain

Abstract

on behalf of the investigators of the PREV-ICTUS Study Abstract-The objective was to assess the stroke risk and prevalence of the cardiovascular risk factors and to analyze their relationship with the specific stroke rates of mortality in each of the autonomic communities of Spain. We conducted a multicenter, cross-sectional study of population Ͼ60 years old in Spanish primary care centers. In all of the subjects, clinical, biochemical, and electrocardiographic data were obtained, and the 10-year stroke risk was calculated using the Framingham score.

A novel method for predicting the risk of thrombosis and thromboembolism

“…Approximately one-third of those with SAH may develop thrombus, according to Redón et al (2007). Limited ambulation as well as immobilization and/or post-operative time in bed (18% of sample), may favor Virchow's triad: venous stasis, endothelial injury and hypercoagulability that can lead to thrombus formation (Bailly, 1950apud Rezende, 2004.…”

Using Public Health Indicators to Measure the Success of Hypertension Control

“…For these analyses to be valid, it must also be assumed that the prevalence and severity of hypertension does not vary substantially across regions. Treatment would be unlikely to equalize lifelong exposure to higher blood pressures, as has occurred in the southern United States compared with other parts of the country.The study by Redon et al,5 together with the other data summarized above, thus suggests that we can begin to consider stroke as a surveillance measure that indicates the quality of hypertension control. Several decades ago, there was general agreement that medical care, as mediated through specific physician encounters, did not have a sufficiently widespread effect to register in basic measures of population health (eg, life expectancy or mortality), which were instead influenced only by living conditions and nutrition.…”

“…The study by Redon et al, 5 together with the other data summarized above, thus suggests that we can begin to consider stroke as a surveillance measure that indicates the quality of hypertension control. Several decades ago, there was general agreement that medical care, as mediated through specific physician encounters, did not have a sufficiently widespread effect to register in basic measures of population health (eg, life expectancy or mortality), which were instead influenced only by living conditions and nutrition.…”

“…Overall, measured patient attributes accounted for almost two thirds of the variation in mortality. 5 As demonstrated in both the United States and the United Kingdom, these more recent estimates of hypertension control from Spain continue to show some modest improvement. 6,7 These data could form the basis of a regional "report card" that could be a useful tool in surveillance and control of CV diseases where medical services are provided on a comprehensive basis.…”

“…A comparison of the United States and Canada with several European countries, however, did suggest a strong relationship among mean blood pressure, the rate of hypertension control, and death from stroke. 4 In this issue of Hypertension, Redon et al 5 add an important new dimension to our understanding of the public health significance of blood pressure control. Using a standardized protocol, they sampled Ͼ7000 patients over the age of 60 years from primary care facilities in the 17 administrative regions in Spain.…”