Blood pressure and low-density lipoprotein cholesterol control status in Chinese hypertensive dyslipidemia patients during lipid-lowering therapy

Abstract

ᅟ: The present study comprised 17,096 Chinese hypertensive dyslipidemia patients who received lipid-lowering treatment for > 3 months in order to investigate blood pressure (BP) as well as low-density lipoprotein cholesterol (LDL-C) goal attainment rates in Chinese hypertensive dyslipidemia patients on antidyslipidemia drugs. The factors that interfered with BP, or BP and LDL-C goal attainment rates and antihypertensive treatment patterns, were analyzed. In total, 89.9% of the 17,096 hypertensive dyslipidemia patients received antihypertensive medications mainly consisting of a calcium channel blocker (CCB) (48.7%), an angiotensin receptor antagonist (ARB) (25.4%) and an angiotensin-converting enzyme inhibitor (ACEI) (15.1%). In cardiology departments, usage rates of β-blockers (19.2%) were unusually high compared to other departments (4.0-8.3%), whereas thiazide diuretics were prescribed at the lowest rate (0.3% vs 1.2-3.6%). The overall goal attainment rates for combined BP and LDL-C as well as BP or LDL-C targets were 22.9, 31.9 and 60.1%, respectively. The lowest BP, LDL-C and BP combined with LDL-C goal attainment rates were achieved in endocrine departments (19.9, 48.9 and 12.4%, respectively). Combination therapies showed no benefit particularly for BP goal achievement. A multivariate logistic regression analysis showed that age < 65 years, alcohol consumption, diabetes, coronary heart disease (CHD), cerebrovascular disease (CVD), chronic kidney disease (CKD), body mass index (BMI) ≥ 28 kg/m2 and not achieving total cholesterol goals were independent predictors for achieving BP, LDL-C or combined BP and LDL-C goals. In summary, the BP and LDL-C goal achievement rates in Chinese dyslipidemia outpatients with hypertension were low, especially in endocrine departments. Combination therapies were not associated with improvement of the goal achievement rates. TRIAL REGISTRATION: Clinical trial registration number NCT01732952.

Keywords: Blood pressure status; DYSIS; Dyslipidemia; Hypertension; Low-density lipoprotein cholesterol.

Conflict of interest statement

Ethics approval and consent to participate

Our study was performed in accordance with the Declaration of Helsinki with regard to ethical principles for research involving human subjects. All patients provided informed written consent before beginning the study and the Ethics Committee of each clinic center approved the protocols.

Consent for publication

Consent for publication was obtained from all enrolled patients.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1

Distribution of patients prescribed antihypertensive treatment in different hospital departments. The monotherapy rate of the cardiology departments was significant different from other departments, #P < 0.01 compared with cardiology departments. The antihypertensive drug treatment rate was significantly different among the departments. It was higher in cardiology than in neurology, endocrinology, general medicine and other departments, *P < 0.01 compared with the cardiology department. Other: departments except general medicine, geriatric, endocrinology, neurology and cardiology.

Fig. 2

a, The percentage of antihypertensive drug distribution in patients with monotherapy; b, The blood pressure goal attainment rates for study patients prescribed various antihypertensive monotherapy. Since diuretics were used as monotherapy in only 1.4% of patients in this population, we excluded diuretics from Fig. 2. The blood pressure control rates among the various monotherapies were significantly different (P < 0.001)

Fig. 3

Blood pressure and LDL-C, and both BP and LDL-C goal attainment rates, of study patients in different departments. a: The blood pressure goal attainment rates of hypertension monotherapy patients, total antihypertensive treatment patients and all enrolled hypertensive dyslipidemia patients. b: Combined blood pressure and LDL-C goal attainment rates in hypertension monotherapy patients, all antihypertensive drug treatment patients and all enrolled hypertensive dyslipidemia patients. c: The blood pressure goal attainment rate, LDL-C goal attainments and BP combined with LDL-C goal attainment rate for all hypertensive dyslipidemia patients *P < 0.05, #P < 0.05, when compared with the department of cardiology. Other: departments except general medicine, geriatric, endocrinology, neurology and cardiology.