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Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents.
This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients' lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mm Hg diastolic.
Of the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt intake also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, education, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control.
Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.
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In order to evaluate the factors of compliance with a lipid lowering therapy, a prospective observational study of patients with hypercholesterolemia using rosuvastatin was carried out.
A total of 2,607 patients who were newly prescribed rosuvastatin were enrolled from 32 family physicians in Korea from March 2009 to December 2009. Of them, 301 patients were excluded due to incomplete data or follow-up compliance data. The patients were regularly observed to ascertain the compliance associated with rosuvastatin at intervals of 12 and 24 weeks. We collected risk factors for the compliance using a structured questionnaire. The criteria for evaluating compliance are to measure clinic attendance, to assess the continuity of therapy, and to calculate the percentage of doses taken.
Among a total of 2,306 patients, the degree of compliance was 54.1%. According to logistic regression analysis, the factors for compliance with the lipid lowering drug included old age (odds ratio [OR], 2.68; 95% confidence interval [CI], 2.09 to 3.45), frequent exercise (OR, 1.76; 95% CI, 1.43 to 2.18), previous statin therapy (OR, 4.02; 95% CI, 3.22 to 5.01), hypertension (OR, 1.80; 95% CI, 1.48 to 2.19), diabetes mellitus (OR, 2.20; 95% CI, 1.69 to 2.87), concomitant medication (OR, 2.28; 95% CI, 1.88 to 2.77), and high coronary heart disease (CHD) risk category (OR, 1.82; 95% CI, 1.39 to 2.38). The compliance decreased with high low density lipoprotein cholesterol levels (OR, 0.20; 95% CI, 0.16 to 0.26).
The compliance of patients using rosuvastatin was 54.1% in primary care. The factors related to higher compliance were old age, regular exercise, previous statin therapy, concomitant medication, presence of hypertension or diabetes, and higher CHD risk level.
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