Risk-factor control in treated hypertensive patients - epidemiological, gender-related, and quality-control aspects

The overall aim was to investigate the risk-factor profile in patients with hypertension, and patients on combined lipid-lowering (LLD) and antihypertensive treatment (AHT) in primary health care, in order to evaluate cardiovascular risk factors in relation to age, gender, lifestyle (smoking), and gender of the physician. Objectives To compare cardiovascular risk factors in smokers with non-smokers in a national sample of treated hypertensives (tHT) (Study I); to evaluate any gender differences in the control of blood pressure (BP) and lipid levels as well as other cardiovascular (CV) risk factors for cardiovascular disease in tHT patients in primary health care (PHC) (Study II); to investigate the relationship of physician's gender to control of blood pressure and lipid levels and CV risk factors in tHT men and women (Study III); to investigate any gender differences in CV risk factors, lipid- and BP control in patients on combined lipid-lowering (LLD) and antihypertensive treatment (AHT), stratified for gender of their physician (Study IV). Methods and materials These cross-sectional clinical studies, of tHTs (Studies I-III) and patients on both AHT and LLD (Study IV) were carried out in 2002-2003 (Study I), 2002-2005 (Studies II and III), and 2002-2006 (Study IV). They were run by 182 (Study I), 264 (Studies II, III) and 356 (Study IV) primary care physicians (PCPs) at primary health care centres (PHCs) in Sweden. The number of patients included were, in Study I, 4,424 tHTs (48% men); in Studies II and III: 6,537 tHTs (48% men) and in Study IV 4,319 patients on both AHT and LLD (53% men). The mean age was 66 years in all four studies. Patients were included retrospectively and consecutively and their data were registered on a web-form. BP and lipid control were defined as SBP/DBP <140/90 mmHg and total cholesterol (TC) <5.0 mmol/l in patients without diabetes mellitus (DM), and SBP/DBP <130/80 mmHg and TC