Cardiovascular risk stratification in primary care patients with arterial hypertension: Results from the Swiss Hypertension Cohort Study (HccH)

Eur J Prev Cardiol. 2019 Nov;26(17):1843-1851. doi: 10.1177/2047487319856732. Epub 2019 Jun 12.

Abstract

Aims: Few data are available on cardiovascular risk stratification in primary care patients treated for arterial hypertension. This study aimed at evaluating the cardiovascular risk profile of hypertensive patients included into the Swiss Hypertension Cohort Study according to the 2013 European Society of Hypertension/European Society of Cardiology Guidelines.

Methods: The Swiss Hypertension Cohort Study is a prospective, observational study conducted by the Centre for Primary Health Care of the University of Basel from 2006 to 2013. Patients with a diagnosis of arterial hypertension (office blood pressure measurement ≥140/90 mmHg) were enrolled. Office blood pressure measurement, cardiovascular risk factors, subclinical organ damage, diabetes mellitus, and established cardiovascular and renal disease were recorded at baseline and at an annual interval during routine consultations by general practitioners in Switzerland.

Results: In total, 1003 patients were eligible for analysis (55.6% male, mean age: 64.0 ± 13.2 years). At baseline, 78.5% of patients presented with either more than three additional cardiovascular risk factors, diabetes mellitus or subclinical organ damage, while 44.4% of patients had a high or very high overall cardiovascular risk. Cardiovascular risk factors and information about diabetes mellitus, established cardiovascular disease and renal disease were recorded mostly completely, whereas substantial gaps were revealed regarding the assessment of subclinical organ damage.

Conclusion: The present findings demonstrate that the majority of primary care patients with arterial hypertension bear a substantial number of additional cardiovascular risk factors, subclinical and/or established organ damage. This emphasizes the need for continuous cardiovascular risk stratification and adequate treatment of arterial hypertension in Switzerland.

Keywords: Arterial hypertension; cardiovascular risk stratification; cohort study; primary care; subclinical and established organ damage.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Albuminuria / epidemiology
  • Cardiovascular Diseases / prevention & control*
  • Cohort Studies
  • Cross-Sectional Studies
  • Data Collection / standards
  • Data Collection / statistics & numerical data
  • Diabetes Mellitus / epidemiology
  • Dyslipidemias / epidemiology
  • Female
  • Guideline Adherence
  • Heart Diseases / epidemiology
  • Humans
  • Hypertension / epidemiology*
  • Male
  • Middle Aged
  • Obesity, Abdominal / epidemiology
  • Practice Guidelines as Topic
  • Primary Health Care*
  • Renal Insufficiency, Chronic / epidemiology
  • Risk Assessment*
  • Smoking / epidemiology
  • Switzerland / epidemiology