Determinantes del control de la presión arterial y los lípidos en pacientes con enfermedad cardiovascular (estudio PREseAP)

Estudio observacional para identificar los determinantes del control de la presión arterial (< 140/90 o < 130/80 mmHg si diabetes) y el colesterol de las lipoproteínas de baja densidad (cLDL < 100 mg/dl) en 1.223 pacientes diagnosticados de enfermedad cardiovascular.El 70,2% eran varones con una media de edad de 66,4 años. El 50,9% (intervalo de confianza [IC] del 95%, 46,9%–54,8%) mostró mal control de la presión arterial y el 60,1% (IC del 95%, 56,3%–63,9%), del cLDL. Determinantes de mal control de la presión arterial fueron: diabetes, hipertensión arterial, no tener diagnóstico previo de insuficiencia cardiaca, diagnóstico de enfermedad arterial periférica o ictus, obeso y no recibir tratamiento hipolipemiante. Determinantes de mal control del cLDL fueron: no recibir tratamiento hipolipemiante, no tener diagnóstico de cardiopatía isquémica, no recibir tratamiento antihipertensivo y dislipemia.Los determinantes de mal control de presión arterial difieren de los del cLDL, resultado que considerar al aplicar las recomendaciones para alcanzar los objetivos terapéuticos en prevención secundaria.

The aim of this observational study was to identify factors influencing the control of blood pressure (i.e., <140/90 mmHg, or <130/80 mmHg in diabetic patients) and low-density lipoprotein (LDL) cholesterol level (<100 mg/dL) in 1223 patients with cardiovascular disease.Overall, 70.2% of patients were men, and their mean age was 66.4 years. Blood pressure was poorly controlled in 50.9% (95% confidence interval [CI], 46.9%–54.8%) and the LDL cholesterol level was poorly controlled in 60.1% (95% CI, 56.3%–63.9%). Determinants of poor blood pressure control were diabetes, hypertension, no previous diagnosis of heart failure, previous diagnosis of peripheral artery disease or stroke, obesity, and no lipidlowering treatment. Determinants of poor LDL cholesterol control were no lipid-lowering treatment, no previous diagnosis of ischemic heart disease, no antihypertensive treatment, and dyslipidemia.The factors affecting blood pressure control were different from those affecting LDL cholesterol control, an observation that should be taken into account when implementing treatment recommendations for achieving therapeutic objectives in secondary prevention.