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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2000-10-25
pubmed:abstractText
Data from the Third National Health and Nutrition Examination Survey, phase 2 (1991 to 1994), indicate that among hypertensive individuals in the United States, 53.6% are treated and only 27.4% are controlled to goal levels. We sought to determine whether poor hypertension control is due to lack of systolic or diastolic blood pressure control, or both. We studied Framingham Heart Study participants examined between 1990 and 1995 and determined rates of control to systolic goal (<140 mm Hg), diastolic goal (<90 mm Hg), or both (systolic <140 and diastolic <90 mm Hg). Of 1959 hypertensive subjects (mean age 66 years, 54% women), 32.7% were controlled to systolic goal, 82.9% were controlled to diastolic goal, and only 29.0% were controlled to both. Among the 1189 subjects who were receiving antihypertensive therapy (60.7% of all hypertensive subjects), 49.0% were controlled to systolic goal, 89.7% were controlled to diastolic goal, and only 47.8% were controlled to both. Thus, poor systolic blood pressure control was overwhelmingly responsible for poor rates of overall control to goal. Covariates associated with lack of systolic control in treated subjects included older age (OR for age 61 to 75 years, 2.43, 95% CI 1.79 to 3.29; OR for age >75 years, 4.34, 95% CI 3.10 to 6.09), left ventricular hypertrophy (OR 1.63, 95% CI 1.04 to 2.54), and obesity (OR for body mass index >/=30 versus <25 kg/m(2), 1.49, 95% CI 1.08 to 2.06). In this community-based sample of middle-aged and older subjects, overall rates of hypertension control were remarkably similar to those in the Third National Health and Nutrition Examination Survey. Poor blood pressure control was overwhelmingly due to lack of systolic control, even among treated subjects. Therefore, clinicians and policymakers should place greater emphasis on the achievement of goal systolic levels in all hypertensive patients, especially those who are older or obese or have target organ damage.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
1524-4563
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
36
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
594-9
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:11040241-Aged, pubmed-meshheading:11040241-Antihypertensive Agents, pubmed-meshheading:11040241-Blood Pressure, pubmed-meshheading:11040241-Blood Pressure Determination, pubmed-meshheading:11040241-Body Mass Index, pubmed-meshheading:11040241-Cholesterol, pubmed-meshheading:11040241-Cholesterol, HDL, pubmed-meshheading:11040241-Cohort Studies, pubmed-meshheading:11040241-Comorbidity, pubmed-meshheading:11040241-Diabetes Mellitus, pubmed-meshheading:11040241-Diastole, pubmed-meshheading:11040241-Electrocardiography, pubmed-meshheading:11040241-Female, pubmed-meshheading:11040241-Health Surveys, pubmed-meshheading:11040241-Humans, pubmed-meshheading:11040241-Hypertension, pubmed-meshheading:11040241-Hypertrophy, Left Ventricular, pubmed-meshheading:11040241-Logistic Models, pubmed-meshheading:11040241-Male, pubmed-meshheading:11040241-Middle Aged, pubmed-meshheading:11040241-Multivariate Analysis, pubmed-meshheading:11040241-Odds Ratio, pubmed-meshheading:11040241-Smoking, pubmed-meshheading:11040241-Systole, pubmed-meshheading:11040241-Treatment Failure, pubmed-meshheading:11040241-United States
pubmed:year
2000
pubmed:articleTitle
Differential control of systolic and diastolic blood pressure : factors associated with lack of blood pressure control in the community.
pubmed:affiliation
National Heart, Lung, and Blood Institute's Framingham Heart Study Framingham, Massachusetts, USA.
pubmed:publicationType
Journal Article