Background. We investigated the association between blood pressure control and common cardiometabolic risk factors from a global and regional perspective. Methods. In the present analysis of a large cross-sectional i-SEARCH study, 17.092 outpatients receiving antihypertensive treatment were included in 26 countries. According to clinical guidelines for the management of arterial hypertension, patients were classified based on the level of seated systolic/diastolic blood pressure (SBP/DBP). Uncontrolled hypertension was defined as SBP/DBP ≥140/90？mmHg for non-diabetics, and ≥130/80？mmHg for diabetics. Results. Overall, mean age was 63.1 years, 52.8% were male, and mean BMI was 28.9？kg/m2. Mean SBP/DBP was 148.9/87.0？mmHg, and 76.3% of patients had uncontrolled hypertension. Diabetes was present in 29.1% with mean HbA1c of 6.8%. Mean LDL-cholesterol was 3.2？mmol/L, HDL-cholesterol 1.3？mmol/L, and triglycerides 1.8？mmol/L; 49.0% had hyperlipidemia. Patients with uncontrolled hypertension had a higher BMI (29.4 versus 28.6？kg/m2), LDL-cholesterol (3.4 versus 3.0？mmol/L), triglycerides (1.9 versus 1.7？mmol/L), and HbA1c (6.8 versus 6.7%) than those with controlled blood pressure ( for all parameters). Conclusions. Among outpatients treated for arterial hypertension, three quarters had uncontrolled blood pressure. Elevated SBP/DBP and uncontrolled hypertension were associated with increasing BMI, LDL-cholesterol, triglycerides, and HbA1c, both globally and regionally. 1. Introduction Arterial hypertension represents a major cause of cardiovascular morbidity and mortality, and affects approximately 1 billion individuals worldwide [1, 2]. Despite the availability of efficient nonpharmacological and pharmacological therapies, blood pressure control rates are largely unsatisfactory, mostly due to underdiagnosis and undertreatment [3]. Furthermore, arterial hypertension is frequently clustered with other metabolic disorders, such as an elevated body mass index (BMI), waist circumference (WC), fasting glucose, triglycerides (TG), and HDL-cholesterol—all of which are associated with adverse cardiovascular outcomes [4–7]. Therefore, international guidelines mandate not only an assessment of the global cardiovascular risk, but also a risk-based approach to antihypertensive therapy [8]. Apart from the impact of the association of an elevated blood pressure with metabolic disorders on patient’s cardiovascular risk, there are also implications from a therapeutic perspective. Recent data have shown independent antihypertensive effects of statins in patients with
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