open access

Vol 11, No 3 (2007)
Prace oryginalne
Published online: 2007-05-31
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Cardiovascular risk in patients with uncontrolled hypertension and its estimation in outpatient setting in Poland. Results of nationwide RAPORT NT programme

Barbara Gryglewska, Joanna Sulicka, Maria Fornal, Barbara Wizner, Arleta Wilkins, Tomasz Grodzicki
Nadciśnienie tętnicze 2007;11(3):187-194.

open access

Vol 11, No 3 (2007)
Prace oryginalne
Published online: 2007-05-31

Abstract


Background The aim of the study was to assess how physicians estimate cardiovascular (CV) risk in patients with uncontrolled hypertension, on an outpatient basis in Poland.
Material and methods The study was a part of educational grant of Servier-Poland. Demographic data, history of diabetes, associated clinical conditions, smoking habit and family history were obtained from patients with uncontrolled hypertension, who visited general practitioners and specialists. Laboratory measurements and occurrence of target organ damage (TOD) were checked in medical records. Blood pressure (BP) and waist circumference, were measured. BP levels were classified and CV risk was estimated according to the Polish Society of Hypertension guidelines 2003. CV risk estimated by physicians and real risk were compared in three groups of uncontrolled hypertension: grade 1-3 (Bowker’s Test of Symmetry). Similar analysis was performed in subgroup of patients with diabetes and/or renal insufficiency.
Results 11 745 patients (mean age - 59.0 ± 11.3, 50.1% men) were examined. CV added risk estimated by physicians was very high in 38.2%, high in 30.4%, moderate in 27.9%, and low in 3.6%, but risk calculated according to the guidelines was 49.6%, 25.1%, 24.2%, 1.1% (respectively), (p < 0.001). Physicians overestimated low, moderate and high risk and underestimated very high added risk. High BP values were strong predictor of underestimation. The same tendency was observed in diabetic patients, but low and moderate risks were incidentally estimated by physicians.
Conclusions Estimation of CV risk according to current guidelines by physicians is imprecise what may influence the intensity of treatment. Educational programs are needed to improve the situation.

Abstract


Background The aim of the study was to assess how physicians estimate cardiovascular (CV) risk in patients with uncontrolled hypertension, on an outpatient basis in Poland.
Material and methods The study was a part of educational grant of Servier-Poland. Demographic data, history of diabetes, associated clinical conditions, smoking habit and family history were obtained from patients with uncontrolled hypertension, who visited general practitioners and specialists. Laboratory measurements and occurrence of target organ damage (TOD) were checked in medical records. Blood pressure (BP) and waist circumference, were measured. BP levels were classified and CV risk was estimated according to the Polish Society of Hypertension guidelines 2003. CV risk estimated by physicians and real risk were compared in three groups of uncontrolled hypertension: grade 1-3 (Bowker’s Test of Symmetry). Similar analysis was performed in subgroup of patients with diabetes and/or renal insufficiency.
Results 11 745 patients (mean age - 59.0 ± 11.3, 50.1% men) were examined. CV added risk estimated by physicians was very high in 38.2%, high in 30.4%, moderate in 27.9%, and low in 3.6%, but risk calculated according to the guidelines was 49.6%, 25.1%, 24.2%, 1.1% (respectively), (p < 0.001). Physicians overestimated low, moderate and high risk and underestimated very high added risk. High BP values were strong predictor of underestimation. The same tendency was observed in diabetic patients, but low and moderate risks were incidentally estimated by physicians.
Conclusions Estimation of CV risk according to current guidelines by physicians is imprecise what may influence the intensity of treatment. Educational programs are needed to improve the situation.
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Keywords

uncontrolled hypertension; estimation of cardiovascular risk; ambulatory care

About this article
Title

Cardiovascular risk in patients with uncontrolled hypertension and its estimation in outpatient setting in Poland. Results of nationwide RAPORT NT programme

Journal

Arterial Hypertension

Issue

Vol 11, No 3 (2007)

Pages

187-194

Published online

2007-05-31

Bibliographic record

Nadciśnienie tętnicze 2007;11(3):187-194.

Keywords

uncontrolled hypertension
estimation of cardiovascular risk
ambulatory care

Authors

Barbara Gryglewska
Joanna Sulicka
Maria Fornal
Barbara Wizner
Arleta Wilkins
Tomasz Grodzicki

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