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Background: Hypertension is the most prevalent major independent risk factor for developing coronary heart disease (CHD). The present analysis aimed to assess blood pressure (BP) distribution and factors associated with insufficient BP control in coronary patients from 24 countries participating in the European Society of Cardiology (ESC) EURoObservational Research Programme (EORP) EUROASPIRE IV survey., Methods: EUROASPIRE IV is a cross-sectional study conducted in 2012-2013 in patients aged 80 years or less hospitalized for CHD with a follow-up visit at a median of 16 months later. Logistic regression analysis was applied to confirm factors associated with BP control defined as less than 140/90 mmHg for nondiabetic patients and less than 140/85 mmHg for diabetic patients., Results: A total of 7998 patients (response rate, 48.7%) attended the follow-up visit. Complete data were available in 7653 participants (mean age 62.5 ± 9.6 years). The BP goal was achieved in 57.6%. Patients failing to achieve the BP goal were older, had higher BMI, had more often a history of coronary artery bypass grafting (CABG) and reported diabetes more frequently. Logistic regression confirmed the following independent significant predictors of not achieving the BP goal: a history of diabetes [odds ratio (OR) 1.75], obesity (OR 1.70 vs. normal BMI), overweight (OR 1.28 vs. normal BMI), age at least 65 years (OR 1.53) and CABG as the index event (OR 1.26 vs. acute MI)., Conclusion: EUROASPIRE IV found insufficient BP control in a large proportion of patients with stable CHD, with diabetes, increased BMI, older age and CABG as the index event being independent predictors of poor BP control.

The purpose: To evaluate longitudinal trends in the prevalence of hyperuricaemia and chronic kidney disease (CKD) in Czech adults with and without arterial hypertension (HT). Materials and methods: Two independent cross-sectional surveys were performed in 2006–2009 and 2015–2018, each screening involving 1% population random sample of the general population of nine districts of the Czech Republic aged 25–64 years, stratified by age and gender. Hyperuricaemia was defined as serum uric acid ≥ 420 μmol/l in men, and ≥ 360 μmol/l in women. CKD was defined as estimated glomerular filtration rate < 60 ml/min/1.73 m2 and/or albumin/creatinine ratio ≥ 3 mg/mmol. Results: Final analyses included 3504 individuals examined in 2006–2009, and 2309 in 2015–2018. The overall prevalence of hyperuricaemia increased from 16.4% to 25.2% in men (p < 0.001), and from 7.6% to 10.9% in women (p < 0.001), whereas the overall prevalence of CKD declined from 6.8% to 3.6% in men (p = 0.001), and from 7.6% to 4.8% in women (p < 0.001). There was no interaction between HT and hyperuricaemia in either gender; the increase in hyperuricaemia prevalence was observed both in hypertensive and normotensive adults and was accompanied by the increased prevalence of abdominal obesity. Contrarily, there was an interaction between HT and CKD in both men (p < 0.001) and women (p = 0.011); the CKD prevalence declined only in hypertensive individuals, specifically in those using antihypertensive medication and was accompanied by the increased use of renin-angiotensin-aldosterone system (RAS) inhibitors and calcium channel blockers (CCBs). Conclusions: Over the period of 10 years, the overall prevalence of hyperuricaemia increased, while the prevalence of CKD decreased. An increase in the prevalence of hyperuricaemia was observed both in hypertensive and normotensive individuals and was accompanied by an increase in the prevalence of abdominal obesity. A decline in the prevalence of CKD was only observed in hypertensive individuals and was accompanied by the increased use of RAS inhibitors and CCBs. [ABSTRACT FROM AUTHOR]

Purpose: Primary aldosteronism (PA) is considered the most common form of secondary hypertension, however, its prevalence, particularly in a general population, is still a matter of debate. The aim of our study was to evaluate the prevalence of PA in a randomly selected general population sample. Materials and methods: A total of 1940 individuals (1% population random sample) aged 25–64 years were screened for major cardiovascular risk factors in six districts of the Czech Republic. Hypertension was defined as a mean of two blood pressure readings ≥140/90 mmHg at one visit or taking antihypertensive medication. Within this population, 740 individuals were labelled as hypertensives and 650 of them sampled for the analysis of direct plasma renin and serum aldosterone. The diagnosis of PA was based on elevated serum aldosterone, low plasma renin and high aldosterone/renin (ARR) ratio and was also verified by a confirmatory test with saline infusion. Results: Positive ARR was found in 52 (8%) individuals (64% women, 36% men, however, due to substatntial proportion of reluctatnt participants to undergo a further work-up (27%), we could confirm the diagnosis of PA only in 13 of them (2%). Aldosterone-producing adenoma was found in one case only, seven patients had idiopathic type and five individuals refused potential surgical treatment therefore, adrenal venous sampling was not performed. Conclusion: Elevated serum aldosterone together with low renin and high ARR were found in 52 (8%) of hypertensives selected from a general population sample, however, the diagnosis of PA was confirmed only in 13 of them (2%). This study based on a general population survey highlighted the difficulty of conducting epidemiological studies on primary aldosteronism in a relatively healthy cohort part of whom did not provide the level of collaboration that is necessary to assess the true prevalence of this condition. [ABSTRACT FROM AUTHOR]

Aim: To examine prevalence and control of the blood pressure (BP) in the general population and in a subgroup of individuals with diabetes mellitus (DM) receiving primary care in the Czech Republic. Methods: A total of 150 primary care physicians examined and recorded the data of 15 consecutive patients (aged ≥45 years) each, irrespective of the visit purpose. A total of 2,211 patients were included; 403 of them had DM. Results: Of the patients screened, 78.4% had hypertension (BP ≥140 and/or ≥90 mm Hg) or were on antihypertensive therapy. In the DM patients, the prevalence of hypertension was higher than 91.3%. Hypertension control (target <130/<80 mm Hg) was only obtained in 18.4% of the general population and in 4.0% of the patients with hypertension and DM. Systolic BP control deteriorated significantly with age, with ≥140 mm Hg present in 75.9–93.1% in the age groups 65–74 years and ≥74 years as compared with 57.1–76.8% in the younger age groups (p = 0.02–0.008). A diastolic BP reduction to <80 mm Hg was achieved in only 8.9–17.2% of the patients. Conclusions: Our survey shows that the target BP is achieved in <5% of the hypertensive patients with DM. The poor hypertension control in patients with DM is primarily due to inadequate systolic BP control, deteriorating significantly with age. The results are alarming and emphasize the need for a more aggressive treatment strategy in patients with DM. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Objective: The aim of our study was to assess longitudinal trends in major CV risk factors in a representative population sample of the Czech Republic. Methods: Three cross-sectional surveys of CV risk factors were conducted within the WHO MONICA project in six Czech districts in 1985 (n =2570), 1988 (n =2768), and 1992 (n =2343). In 1997/98, 2000/01, and 2007/08, another three screenings for CV risk factors (a 1% random sample, aged 25–64, mean age 45 years) were conducted in the six original districts (n =1990; 2055; and 2246, respectively). Results: Over a period of 22/23 years, there was a significant decrease in the prevalence of smoking in males (from 45.0 to 30.5%; p <0.001) and no change in smoking habits in females. BMI increased in males and did not change in females. Both systolic and diastolic blood pressure decreased significantly in both genders, while the prevalence of hypertension declined only in females. Awareness of hypertension also rose as did the proportion of individuals treated by antihypertensive drugs in both genders. Hypertension control improved in either gender. A remarkable drop in total cholesterol was seen in both sexes (males: from 6.21±1.29 to 5.29±1.10mmol/L; p <0.001; females: from 6.18±1.26 to 5.30±1.06mmol/L; p <0.001). Conclusions: The striking improvement in CV risk factors documented between 1985 and 2007/8 most likely contributed to the decrease in CV mortality in the Czech Republic. [ABSTRACT FROM AUTHOR]