Concomitant risk factors in hypertensives: a survey of risk factors for cardiovascular disease amongst hypertensives in English general practices.

Aims: To determine the prevalence of cardiovascular risk factors among hypertensives in a cross-sectional survey of hypertensives from 13 general practices in England.

Findings: Of 1,948 European hypertensives (systolic blood pressure 150 mmHg and/or diastolic blood pressure > 90 mmHg and/or on treatment for hypertension), 40 to 69 years of age, 53.3% on treatment had controlled blood pressures (systolic blood pressure < 160 mmHg and diastolic blood pressure < 95 mmHg). Electrocardiographic abnormalities and other cardiovascular risk factors were common among these hypertensives, with dyslipidaemia, past or current smoking and lack of physical exercise being present in the majority of those studied. All risk factors except reported diabetes were more prevalent amongst subjects from northern practices, where coronary heart disease rates are higher. Compared with those on no therapy, those receiving diuretics only had significantly higher levels of serum total cholesterol (6.39 mmol/l vs 6.69 mmol/l: p < 0.01), and those receiving beta-blockers only had significantly higher levels of triglycerides (2.32 mmol/l vs 2.64 mmol/ l: p < 0.01), and lower levels of HDL-cholesterol (1.33 mmol/l vs 1.23 mmol/l: p < 0.001).

Conclusion: It is important to consider other cardiovascular risk factors in hypertensives because they are very common and interact with blood pressure (BP) to determine levels of risk. The high proportion of inadequately controlled hypertensives demands a more effective management strategy.