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Therapeutic Goal Attainment in Patients With Hypertension and Dyslipidemia

Bibliographic Data

ID9103461
AuthorsMichael L Johnson (0000-0002-4018-4647, Michael E. DeBakey VA Medical Center, corresponding author), Kenneth Pietz (Michael E. DeBakey VA Medical Center, corresponding author), David S Battleman, David Battleman (University of Pennsylvania), Rebecca J Beyth (0000-0003-1727-1133)
Year2006
Volume44
Issue1
Pages39-46
Publication date2006-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/01.mlr.0000188982.25397.37
PMID16365611
OpenAlexW2038291971
LanguageEN
Citations received1
References cited28

BACKGROUND: Recent guidelines emphasize the need to assess and treat overall risk for cardiovascular disease through the concomitant management of multiple risk factors. We sought to ascertain treatment patterns and attainment of therapeutic goals in patients with isolated and concomitant hypertension and dyslipidemia, both with and without diabetes mellitus (DM) and symptomatic cardiovascular disease. METHODS: Inception cohorts of more than 41,000 newly diagnosed hypertension and dyslipidemia patients from 6 medical centers of the south-central Veterans Affairs health care system were evaluated. Treatment patterns and goal attainment for low-density lipoprotein cholesterol (LDL-C; Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults guidelines: <160, <130, or <or=100 mg/dL depending on risk factors) and blood pressure (BP; Joint National Committee 6: <140/90 or <130/85 mm Hg depending on risk factors) were measured at 1 year. Separate analyses were conducted in patients with and without DM and symptomatic cardiovascular disease. RESULTS: Treatment rates in patients with and without DM and symptomatic disease ranged from 46.6% to 71.3% in patients with hypertension only, from 31.5% to 64.1% in patients with dyslipidemia only, and from 64.3% to 91.3% in patients with both conditions. Among asymptomatic patients, 40.6% of nondiabetics and 20.6% of patients with DM with isolated hypertension reached BP targets. Attainment of LDL-C goals was slightly higher and reached 52.8% among patients with DM with concomitant hypertension. Among symptomatic patients, attainment of all goals was <40% for all groups. The proportion of asymptomatic patients with concomitant disease reaching goal for both BP and LDL-C was 24.4% among nondiabetics and 15.4% among patients with DM; these proportions decreased to 13.6% and 13.4% respectively, among patients with symptomatic cardiovascular disease. CONCLUSIONS: The majority of patients were receiving pharmacological treatment of hypertension and dyslipidemia, yet attainment of therapeutic goals was generally <50%. Further work is needed to determine factors related to improvement in management and outcomes of patients with multiple cardiovascular risk factors

Asymptomatic · Blood pressure · Concomitant · Diabetes mellitus · Disease · Dyslipidemia · Metabolic syndrome · National Cholesterol Education Program · Physical therapy · Cardiac Health and Mental Health · Endocrinology · Health Promotion and Cardiovascular Prevention · Internal Medicine · Lipoproteins and Cardiovascular Health · Medicine

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    Open Access•Tamer F Desouky, Pablo A Mora et al.•Quality of Life Research•2012

  • Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

    Aram V Chobanian, George L Bakris et al.•Hypertension•2003

  • Trends in Prevalence, Awareness, Treatment, and Control of Hypertension in the United States, 1988-2000

    Ihab Hajjar•JAMA•2003

Unique citing works1
Citations per year0,07
Citation span2012 - 2012 (1)
Citation velocityhistorical
Highly citedNo
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