Lack of control of hypertension in primary cardiovascular disease prevention in Europe: Results from the EURIKA study
Abstract
Background The prevalence of and factors associated with uncontrolled hypertension and apparent resistant hypertension were assessed in the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; NCT00882336).Methods EURIKA was a cross-sectional observational study including patients being treated for the primary prevention of cardiovascular disease in 12 European countries. Patients were assessed if they were being treated for hypertension (N=5220). Blood pressure control was defined according to European guidelines, with sensitivity analysis taking account of patients' age and diabetes status. Associated factors were assessed using multivariate analysis.Results In the primary analysis, a total of 2691 patients (51.6%) had uncontrolled hypertension. Factors significantly associated with an increased risk of having uncontrolled hypertension included female sex (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.93-2.73), body mass index (BMI; OR per kg/m(2): 1.03; 95% CI: 1.01-1.04), and geographic location. A total of 749 patients (14.3%) had apparent resistant hypertension. Factors significantly associated with an increased risk of having apparent resistant hypertension included BMI (OR per kg/m(2): 1.06; 95% CI: 1.04-1.08), diabetes (OR: 1.28; 95% CI: 1.06-1.53), use of statins (OR: 1.36; 95% CI: 1.15-1.62), serum uric acid levels (OR: 1.16; 95% CI: 1.09-1.23), and geographic location. Similar results were seen in sensitivity analyses.Conclusions Over 50% of patients treated for hypertension continued to have uncontrolled blood pressure and 14.3% had apparent resistant hypertension. Positive associations were seen with other cardiovascular risk factors.
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Among treated adults with hypertension, prevalent apparent treatment-resistant hypertension occurs in 15% to 18% of clinic-based samples.
“Among treated adults with hypertension, prevalent aTRH occurs in ≈12% to 15% of population-based13–16 and 15% to 18% of clinic-based reports.17–20”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [17]
Resistant hypertension has been linked to metabolic derangements, including hyperuricemia, aldosterone excess, and suppressed circulating renin levels (approximately 60% of those with resistant hypertension have suppressed renin levels).
“RH has also been linked to metabolic derangements, including hyperuricemia,17 aldosterone excess,47 and suppressed circulating renin levels (≈60% of those with RH have suppressed renin levels).57”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [17]
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- Authors
- Borghi, C., Tubach, F., De Backer, G., Dallongeville, J., Guallar, E., Medina, J., Perk, J., Roy, C., Banegas, J. R., Rodriguez-Artalejo, F., & Halcox, J. P.
- Affiliations
- University of Bologna (IT)
- Inserm (FR)
- AstraZeneca (Spain) (ES)
- Linnaeus University (SE)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES)
- Swansea University (GB)
- Corresponding author
- Borghi, Claudio
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2016-09
- Volume
- 218
- Pages
- 83-88
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2378917168
- Cited by
- 102
- References
- 26
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 9 · 2023: 10 · 2022: 8 · 2021: 10 · 2020: 20 · 2019: 15 · 2018: 9 · 2017: 10 · 2016: 6
- FWCI
- 10.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Funders
- AstraZeneca
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- uncontrolled hypertension, resistant hypertension, blood pressure control, primary prevention of cardiovascular disease, cardiovascular risk factors, body mass index, diabetes mellitus, statin use, serum uric acid, sex differences, regional variation
- MeSH terms
- Aged, Cardiovascular Diseases, Cross-Sectional Studies, Europe, Female, Humans, Hypertension, Male, Middle Aged, Primary Prevention, Risk Factors
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