Determinants of poor hypertension management in patients with ischaemic heart disease

Figures & data

Table I. Characteristics of participants with and without hypertension (as defined in the methods section).

	Participants with hypertension, n = 593	Participants without hypertension, n = 252	p
Age (years)	59.8±7.9	56.2±8.7	<0.05
Sex (men)	67.8%	80.0%	<0.05
Duration of education (years)	11.4±3.6	11.6±3.5	NS
Index event			NS
Acute MI	26.6%	28.2%
Unstable angina	24.3%	18.2%
PCI	26.6%	27.0%
CABG	22.5%	26.6%
Hospital setting			NS
University hospital	51.4%	54.4%
Community hospital	48.6%	45.6%
Practice setting			NS
Hospital outpatient clinic	40.3%	38.9%
General practitioner	48.7%	47.6%
Private cardiology practice	9.1%	10.7%
Without any physician	1.9%	2.8%
Time from index hospitalization (months)	13.6±4.9	14.4±4.8	<0.05
Employment	16.2%	20.2%	NS
Smoking	14.0%	21.0%	<0.05
Hypercholesterolemia^a	84.9%	82.6%	NS
Diabetes	19.9%	9.9%	<0.05
Obesity^b	29.5%	17.3%	<0.05
Myocardial infarction prior to index hospitalization	42.7%	42.1%	NS
Heavy alcohol drinking^c	20.4%	26.2%	= 0.066
Physically active^d	69.6%	76.0%	= 0.061

MI, myocardial infarction; PCI, percutaneous coronary intervention; CABG, coronary artery bypass grafting.

^aTotal cholesterol level ⩾5.2 mmol/l and/or lipid‐lowering drug.

^bBody mass index ⩾30 kg/m².

^c⩾3 drinks per day.

^dLeisure time activity >1 h per week.

Table II. Proportions of patients with undetected, untreated and uncontrolled hypertension according to demographic, healthcare and cardiovascular risk factors.

	Undetected hypertension		Untreated hypertension		Uncontrolled hypertension
	%	p‐value	%	p‐value	%	p‐value
Age		NS		NS		<0.01
<60 (n = 287)	18.1		6.9		64.1
⩾60 (n = 306)	17.0		7.7		74.5
Sex		<0.05		<0.05		NS
Men (n = 402)	20.2		9.0		68.8
Women (n = 191)	12.0		3.7		69.1
Duration of education		<0.05		NS		NS
⩽13 years (n = 447)	15.7		7.8		69.7
>13 years (n = 146)	23.4		5.5		66.2
Index event		NS		<0.05		NS
Acute MI (n = 158)	18.4		5.1		64.6
Unstable angina (n = 144)	18.2		11.9		71.3
PCI (n = 158)	17.8		3.8		68.2
CABG (n = 133)	15.8		9.0		72.2
Hospital setting		NS		= 0.05		NS
University hospital (n = 305)	17.4		5.3		69.4
Community hospital (n = 288)	17.8		9.4		68.3
Practice setting		NS		<0.05		NS
Hospital outpatient clinics (n = 239)	19.8		5.5		68.1
General practitioners (n = 289)	15.3		8.0		67.7
Private cardiology practices (n = 54)	16.7		3.7		74.1
Irregular health check (n = 11)	36.4		45.5		90.9
Employment		NS		NS		NS
Not employed (n = 497)	16.9		7.3		69.6
Employed (n = 96)	21.0		7.4		65.3
Time from index hospitalization		NS		NS		NS
<1 year (n = 280)	15.4		6.4		68.8
⩾1 year (n = 313)	19.5		8.0		68.9
Smoking		NS		NS		NS
Yes (n = 83)	15.7		10.8		62.7
No (n = 510)	17.9		6.7		69.9
Hypercholesterolemia		NS		NS		NS
Yes (n = 501)	17.4		7.8		67.7
No (n = 92)	19.1		4.5		75.3
Diabetes		<0.05		NS		NS
Yes (n = 114)	8.0		5.3		68.1
No (n = 479)	20.1		7.7		68.3
BMI		= 0.07		NS		NS
⩾30 kg/m^2 (n = 174)	13.2		7.5		68.4
<30 kg/m^2 (n = 419)	19.5		7.2		69.0
The history of MI		<0.05		NS		NS
Yes (n = 253)	22.5		7.5		69.2
No (n = 340)	14.4		6.8		68.5
Heavy alcohol drinking ^a		NS		<0.01		NS
Yes (n = 117)	22.2		16.2		70.3
No (n = 476)	16.5		5.3		63.3
Physically active ^b		NS		NS		NS
Yes (n = 408)	19.6		7.1		69.9
No (n = 185)	13.6		7.9		66.1
Blood pressure lowering drugs at discharge		<0.001		<0.001		NS
Yes (n = 558)	15.7		5.0		68.4
No (n = 35)	46.9		43.8		78.1
Hypertension awareness		<0.001		<0.001		= 0.066
Yes (n = 516)	10.7		5.1		67.5
No (n = 77)	89.3		22.1		77.9
Overall	17.5		7.1		68.9

MI, myocardial infarction; PCI, percutaneous coronary intervention; CABG, coronary artery bypass grafting; BMI, body mass index.

^a⩾3 drinks per day.

^bLeisure time activity >1 h per week.

Table III. Independent predictors of undetected, untreated and uncontrolled hypertension in hypertensive ischaemic heart disease patients (n = 593).

	Odds ratio	95% CI
Undetected hypertension
Sex (men – 1, women – 0)	1.75	1.05–2.90
History of myocardial infarction^a (yes – 1, no – 0)	1.67	1.03–2.72
Diabetes (yes – 1, no – 0)	0.35	0.17–0.72
Untreated hypertension
Practice setting (irregular health check – 1, other practice settings – 0)	16.27	4.13–64.00
Heavy alcohol drinking^b (yes – 1, no – 0)	3.26	1.52–6.98
Unstable angina^c (unstable angina – 1, other discharge diagnoses – 0)	2.68	1.25–5.77
Hypertension awareness (yes – 1, no – 0)	0.22	0.10–0.50
Blood pressure lowering drugs at discharge (yes – 1, no – 0)	0.08	0.03–0.19
Uncontrolled hypertension
Age (per 10 years)	1.27	1.02–1.58
Hypertension awareness (yes – 1, no – 0)	0.57	0.32–1.00

CI, confidence intervals.

^aPrior to index hospitalization.

^b⩾3 drinks per day.

^cIndex diagnosis.

Figure 1 The rates of antihypertensive drugs use at the time of follow‐up interview in hypertensive patients with ischaemic heart disease according to the level of blood pressure.