Characteristics and Future Cardiovascular Risk of Patients With Not-At-Goal Hypertension in General Practice in France: The AVANT'AGE Study

Although many studies focus on patients with resistant hypertension, general practitioners (GPs) are more likely to face patients in clinical practice with not-at-goal hypertension, whose antihypertensive treatment needs to be modified. However, information regarding such patients is limited. In the present study, 710 GPs in France each included their first 10 not-at-goal hypertensive patients, ie, the patients for whom they decided to modify antihypertensive treatment. The study population was composed of 7032 patients (58% men, mean age 62.4 +/- 11.5years). Anthropometric and biologic measurements and clinical data were collected, and vascular age and 10-year cardiovascular risk were estimated by standard formula. Of 7032 participants, cardiovascular risk factors were prevalent, with 15.1% current smokers, 26.1% obese, 22.8% with diabetes mellitus, 35.1% with dyslipidemia, 12.0% with left ventricular hypertrophy, and 4.9% with renal insufficiency. In the subgroup (n=4697) of patients aged between 30 and 74years and undergoing primary cardiovascular prevention, vascular age was superior (13 to 28years) when compared with chronological age in different subgroups. The patients' estimated 10-year cardiovascular global risk was 25.3 +/- 13.6%, with 16.0 +/- 10.5% for coronary heart disease, 8.7 +/- 6.8% for myocardial infarction, 5.8 +/- 4.5% for stroke, and 6.8 +/- 6.6% for cardiovascular mortality. Patients with not-at-goal hypertension in primary care bear a heavy burden of cardiovascular diseases.