Objective: To investigate the blood pressure control rate and related influencing factors in hypertensive outpatients.
Methods: In this multicentre, cross-sectional registration survey, hypertensive outpatients were recruited from department of cardiology, nephrology and endocrinology of 92 tertiary hospitals in 22 cites across China. Each centre enrolled more than 50 hypertensive outpatients aged 18 years or older between 20 April 2009 and 31 May 2009. Outpatients were surveyed by clinical interview with BP measurement and questionnaire.
Results: A total of 5086 subjects were enrolled, 2032 in department of cardiology, 1510 in department of endocrinology and 1544 in department of nephrology, 27.1% and 25.3% patients were in Grade 2 or Grade 3 hypertension, 37.2% patients were complicated with diabetes, 22.4% with coronary artery disease, and 18.4% with renal-dysfunction. Overall, controlled BP was achieved in 30.6% patients. The control rate was 45.9% in uncomplicated hypertensive patients, 31.3% in hypertensive patients with coronary artery disease, 14.9% in patients with diabetes, and 13.2% in patients with renal-dysfunction. Calcium channel blocker (56.6%) and angiotensin-II receptor blockers (32.0%) were the most frequently used medications. The mean number of antihypertensive agents prescribed per patient was 1.73, over 54.1% patients were treated with more than 2 antihypertensive drugs. Combination therapy or single-pill combination with various anti-hypertensive components was prescribed to 8.3% and 12.7% hypertensive patients as initial therapy. Multiple logistic regression analysis showed that lower BMI, no alcohol intake, free medical care, no diabetes, no renal-dysfunction, lipid-lowering therapy, shorter interval of visiting physicians, regular taking antihypertensive medications, physical activity were the factors related to satisfactory blood pressure control rate in hypertensive outpatients.
Conclusions: Blood pressure control rate among Chinese hypertensive outpatients was increased compared with epidemiological survey in 2002. BMI, co-morbidities, lower combination treatment rate, poor compliance were the key reasons for lower BP control rate. Increased use of combination therapy instead of monotherapy should be encouraged to hypertensive outpatients to improve BP control rate.