We appreciate the article “Uncontrolled arterial hypertension in primary care – patient characteristics and associated factors” written by Corinne Chmiel et al. and read with great interest . The study concluded that age, smoking and high body mass index (BMI) measurements are strong independent factors associated with higher blood pressure levels in patients with uncontrolled arterial hypertension and pointed to the importance of adequate pharmacological treatment as well as risk factor control . The subject is important in terms of our daily practice and the study deserves emphasising with its successful design and results.
Hypertension is a growing healthcare problem and constitutes a major risk factor for the development of atherosclerotic cardiovascular disease . The proper blood pressure control and suitable follow up of the patients will prevent many probable comorbidities that may appear in an individual patient .
As we know, coronary artery disease may be related to blood pressure dysregulation. If the authors defined independent factors associated with higher blood pressure levels in patients with coronary artery disease, the results could be different. In addition, the proper blood pressure control may also be impaired by the cardiovascular risk factors such as diabetes mellitus or hypercholesterolaemia. Lifestyle change programmes may additionally improve the regulation of blood pressure. The authors may indicate whether there are differences in these factors between the two groups.
In addition, the study has a cross-sectional design and did not follow the patients. We think that in order to make better comments about the effects of age, body mass index and smoking on hypertension and the number of drugs on blood pressure control, it would be better if these patients were followed for a particular time.
Correspondence: Sevket Balta, MD, Department of Cardiology, Gulhane School of Medicine, Tevfik Saglam St., TR - 06018 Etlik-Ankara, Turkey, drsevketb[at]gmail.com
1 Chmiel C, Wang M, Senn O, Del Prete V, Zoller M, Rosemann T, et al. Uncontrolled arterial hypertension in primary care – patient characteristics and associated factors. Swiss Med Wkly. 2012;142:w13693 http://www.smw.ch/content/smw-2012-13693/ .
2 Brenner R, Waeber B, Allemann Y. Medical treatment of hypertension in Switzerland. The 2009 Swiss Hypertension Survey (SWISSHYPE). Swiss Med Wkly. 2011;141:w13169 http://www.smw.ch/content/smw-2011-13169/ .
3 Merlo C, Bally K, Tschudi P, Martina B, Zeller A. Management and outcome of severely elevated blood pressure in primary care: a prospective observational study. Swiss Med Wkly. 2012;142:w13507 http://www.smw.ch/content/smw-2012-13507/ .
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