Factors associated with uncontrolled hypertension and cardiovascular risk in hypertensive 60-year-old men and women-a population-based study

The objective of this study was to describe cardiovascular risk profiles of 60-year-olds with uncontrolled diagnosed hypertension (>= 140/90 mm Hg) in comparison with individuals with controlled diagnosed hypertension. To study how medical, lifestyle and socioeconomic factors are associated with uncontrolled diagnosed hypertension in men and women separately, a population-based, cross-sectional study of 4228 60-year-olds in Sweden, of whom 503 men and 445 women had previously diagnosed hypertension, was conducted. Physical examination including measuring blood pressure was carried out, and a medical/lifestyle/socioeconomic questionnaire was completed. Only 22% of the men and 33% of the women with diagnosed hypertension had a blood pressure below 140/90 mm Hg. Both men and women had multiple cardiovascular risk factors in addition to hypertension. Antihypertensive monotherapy was more common in men and women with controlled hypertension. None of the participants without pharmacological treatment had a controlled blood pressure. Four factors were independently associated with uncontrolled hypertension in men: waist circumference above 97 cm (odds ratio (OR)=1.85, confidence interval (CI)=1.17-2.92), coronary heart disease (CHD) (OR=0.28, CI=0.17-0.46), no health care for financial reasons (OR=2.71, CI=1.09-6.78) and daily intake of fruit (OR=0.59, CI=0.37-0.93). In women, three factors remained independently associated: waist circumference above 78 cm (OR=1.93, CI=1.09-3.43), CHD (OR=0.36, CI=0.18-0.72) and living in an apartment (OR=0.55, CI=0.35-0.85). More efforts are warranted to reduce blood pressure and to modulate associated risk factors to be able to reduce the high morbidity and mortality observed in individuals with hypertension. Hypertension Research (2009) 32, 780-785; doi: 10.1038/hr.2009.94; published online 26 June 2009