Blood pressure and antihypertensive therapy according to the global cardiovascular risk level in Italy: the CHECK Study

Eur J Cardiovasc Prev Rehabil. 2010 Oct;17(5):562-8. doi: 10.1097/HJR.0b013e328338a4c6.

Abstract

Background: Elevated blood pressure (BP) is one of the most important modifiable risk factors for cardiovascular diseases. In this study we assessed the excess of cardiovascular risk attributable to high BP and antihypertensive treatment in a sample of Italian patients enrolled by the 'Cholesterol and Health: Education, Control and Knowledge' (CHECK) study.

Methods: CHECK is a large, cross-sectional epidemiological study, which randomly enrolled patients aged 40-79 years from 425 Italian General Practices from March 2002 to April 2004. Among 5731 patients enrolled in the study [49.6% men, mean age (standard deviation) 57.7 (10.3) years], 723 (12.6%) had 'optimal' BP, 1496 (26.1%) had 'high normal' BP, and 1942 (33.9%) were hypertensive.

Results: According to the European Guidelines stratification of the cardiovascular risk-excess attributable to high BP, 34.7% of the sample had a low added risk and 53.2% had a moderate-to-very high added risk. The pharmacological therapy was prescribed in 22.3, 43.9, 61.4, and 76.9% of the patients with low, moderate, high, and very high added risk, respectively.

Conclusion: Overall dietary and drug therapies are under prescribed, as most of the treated patients would require two additional antihypertensive drugs to meet the recommended BP target. This effort could provide significant individual benefit to moderate/high-risk patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control*
  • Cross-Sectional Studies
  • Drug Prescriptions
  • Drug Utilization
  • Female
  • General Practice
  • Guideline Adherence
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Italy
  • Male
  • Middle Aged
  • Odds Ratio
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'*
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome

Substances

  • Antihypertensive Agents