European Primary Care Cardiovascular Society

Increased mortality in patients with delayed BP control after first diagnosis

The prognostic value of blood pressure control delay in newly diagnosed hypertensive patients

Literature - Martın-Fernandez M, Vinyolesa E, Real J, et al. - J Hypertension 2018;36: published online ahead of print

Introduction and methods

Data from small sub-studies suggest that a delay in blood pressure (BP) management after initial diagnosis is associated with an increased cardiovascular (CV) risk. Evidence from studies specifically designed to study this relation is lacking to date [1-3].

In this retrospective cohort study, the effect of delayed BP control in patients with newly diagnosed hypertension on CV morbidity and mortality was evaluated in everyday clinical practice. Moreover, the time needed to reach good BP control in individuals >60 years with a recent diagnosis of hypertension was assessed, and the variables associated with delays were identified.

For this purpose, data from electronic clinical records were collected for 2007 until 2012, including patients with hypertension, who were not receiving antihypertensive medication and had no CV disease at baseline. A total of 18,721 patients were eligible for the analysis, with a mean age of 71.6 years, out of whom 57% were women. The main variables of interest were the time between diagnosis and control of BP (diagnostic-control time, D-C), defined as the first registered measurement of BP <140/90 mm Hg after diagnosis, as well as the appearance of the first CV event or all-cause death.

Main results


Delaying BP control in newly diagnosed patients with hypertension is independently associated with higher all-cause mortality. Such a delay is a modifiable risk factor, which should be taken into account in clinical practice. Moreover, this study showed that male sex, age, diabetes, smoking and lower DBP were independently associated with all-cause mortality.


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