2Medical Faculty, University of Prishtina, Prishtina, Kosovo
3German Heart Centre, Technical University, Munich, Germany
Abstract
Objective: The epidemiological data have shown that the goal blood pressure (BP) control is achieved in only a small percentage of the hypertensive patients. The aim of this study was to assess the quality of the management of arterial hypertension (AH) in patients hospitalized in Service of Cardiology, University Clinical Centre of Kosovo, in Prishtina, and to determine the predictors of uncontrolled AH. Methods: This retrospective study included 938 consecutive hypertensive patients (63.1±11.3 years, 55.1% females), admitted to our institution between January 2003 and June 2006. Systolic and diastolic blood pressure, blood analyses, drug prescription and echocardiographic findings were analyzed in all study patients. Multiple regression analysis was used to identify the independent associates of poor BP control. Results: Overall, 83%f of patients were discharged on angiotensin-converting enzyme inhibitors (A), 71% - on beta-blockers (B), 26% - on calcium channel blockers (C) and 60% - on diuretics (D). The most frequent drug combination used was ABD (30.5%), followed by AB (18%) and AD (8%). The goal systolic and diastolic BP was achieved in 50% of patients. Multivariate analysis identified diabetes, (OR=0.479, 95% confidence interval [CI] 0.339-0.677, p<0.001), creatinine level (OR=0.997, 95% CI 0.996-0.999, p=0.001], and ABCD combination therapy (OR=0.445, 95% CI 0.253-0.774, p=0.046)], as independent correlates of in-hospital poor BP control. Conclusions: Half of hypertensive patients hospitalized in the Service of Cardiology had achieved the goal blood pressure. The diabetes, level of creatinine and a combination of 4 antihypertensive drugs were independent predictors of poor hypertension control.