Risk factor control in treated hypertensives from Estonia and Sweden. Why the difference?
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Background. It is of importance to study the risk factor control in treated hypertensives (tHT), both longitudinally within one country and between neighbouring countries, as hypertensive patients still run an increased cardiovascular risk in spite of treatment. Methods. In sample of 1135 tHT from Estonia and a similar number of age- and sex- matched Swedish tHT, the control of blood pressure and other cardiovascular risk factors were assessed as part of national surveys in primary health care. Data were retrieved form consecutive patients visiting primary health care centres all over each country. Results. The mean age of male patients (n=421) was 50 years and for female patients (n=714) it was 52 years. tHT from Sweden were more likely to be in better control of blood pressure and risk factor levels than corresponding Estonian patients, matched for age and gender. However, there was a significantly (p=0.0003) higher rate of smoking in Swedish female patients (22.4%) than in corresponding Estonian patients (16.0%). More Swedish women than men were prescribed thiazide diuretics, but fewer were prescribed angiotensin- converting enzyme (ACE) inhibitors. No similar Estonian data were available. Conclusion. Most cardiovascular risk factors were better controlled in the Swedish hypertensives, except for a higher smoking prevalence in Swedish female patients. This could be related not only to differences in clinical practice, but also influenced by social and lifestyle factors.