Relationship between cardiovascular risk profile and antihypertensive druguse

BACKGROUND: Hypertension guidelines emphasize the selection of antihyperten sive treatment on the basis of absolute cardiovascular risk. Moreover, comp elling and possible indications for each antihypertensive drug class are re commended for patients with other concomitant conditions. The aim of the pr esent study was to analyze the relationship between the cardiovascular risk profile and co-morbid conditions on antihypertensive drug class use. METHODS: This is an observational, multicenter, cross-sectional study perfo rmed in 2,850 essential hypertensive patients. Antihypertensive drug treatm ent has been evaluated on the basis of the presence of other cardiovascular risk factors, target organ damage or cardiovascular diseases, as well as t he absolute cardiovascular risk profile. RESULTS: Patients with diabetes were treated more frequently with calcium c hannel blockers (CCB) and ACE inhibitors. However, the presence of hypercho lesterolemia or smoking habit did not influence the use of antihypertensive drug classes. The presence of cerebrovascular disease increased the use of CCB and ACE inhibitors, whereas coronary disease increased the use of CCB and betablockers. The use of diuretics and angiotensin II receptor antagoni sts was increased in patients with cardiac failure, whereas neither betablo ckers nor ACE inhibitors were affected by this concomitant disease. Patient s with the highest cardiovascular risk received more antihypertensive treat ment than those with lower risk, but this was not accompanied by switching from old classes to new ones. CONCLUSION: Cardiovascular risk profile seems to have little influence on t he use of antihypertensive drug classes, particularly the presence of hyper cholesterolemia or cardiac failure. It seems adequate to emphasize the nece ssity of an individualization of antihypertensive treatment, based on the p resence of concomitant conditions that influence the absolute cardiovascula r risk.