Management of high-risk patients with hypertension and left ventricular hypertrophy in Germany: differences between cardiac specialists in the inpatient and outpatient setting

Völler, Heinz; Sonntag, Frank J.; Thiery, Joachim; Wegscheider, Karl; Luft, Friedrich C.; Bestehorn, Kurt
January 2006
BMC Public Health;2006, Vol. 6, p256
Academic Journal
Background: Among patients with hypertension, those with established left ventricular hypertrophy (LVH) represent a high risk cohort with poor prognosis. We aimed to investigate differences in characteristics and health care management of such patients treated as inpatients or outpatients by cardiac specialists. Methods: Prospective cross-sectional study in patients with hypertension and LVH who were referred to either inpatient care (rehabilitation hospitals) or to outpatient care (cardiology practices). Results: A total of 6358 inpatients (59.6% males; mean age 66.6 years) and 2246 outpatients (59.5% males; mean age 63.2 years) were followed up for a mean of 23 vs. 52 days, respectively. Inpatients compared to outpatients had a significantly higher prevalence of coronary heart disease, history of stroke, renal failure or diabetes. Mean blood pressure of inpatients compared to outpatients was significantly lower both at entry (150/84 vs. 161/93 mmHg) and at end of follow-up (129/75 vs. 139/83 mmHg). After adjustment for baseline blood pressure and a propensity score, differences between out- and inpatients at end of follow-up were 8.0/5.1 mmHg in favour of inpatients. Blood pressure goals as specified by guidelines were not met by 32% of inpatients and 55% of outpatients. Conclusion: Inpatients had a higher rate of comorbidities and more advanced atherosclerotic disease than outpatients. Control of hypertension of inpatients was already better on admission than in outpatients, and treatment intensity in this group was also higher during the observation period. While blood pressure lowering was substantial in both groups, there were still a high proportion of patients who did not achieve treatment goals at discharge.


Related Articles

  • Clinical Implication of Coronary Tortuosity in Patients with Coronary Artery Disease. Li, Yang; Shen, Chengxing; Ji, Yanan; Feng, Yi; Ma, Genshan; Liu, Naifeng // PLoS ONE;2011, Vol. 6 Issue 8, p1 

    Background: Coronary tortuosity (CT) is a common coronary angiography finding. The exact pathogenesis, clinical implication and long-term prognosis of CT are not fully understood. The purpose of this study is to investigate the clinical characteristics of CT in patients with suspected coronary...

  • Screening coronary CT angiography: possibilities and pitfalls. Yoo, Seung; Lee, Hwa; White, Charles // International Journal of Cardiovascular Imaging;Dec2014, Vol. 30 Issue 8, p1599 

    No abstract available.

  • Type D personality is unrelated to major adverse cardiovascular events in patients with coronary artery disease treated by intracoronary stenting. Meyer, Thomas; Hussein, Sharif; Lange, Helmut; Herrmann-Lingen, Christoph; Lange, Helmut W // Annals of Behavioral Medicine;Oct2014, Vol. 48 Issue 2, p156 

    Background: Previous research in cardiac patients suggested that type D personality, defined as a combination of negative affectivity (NA) and social inhibition (SI), was associated with adverse outcome.Purpose: The objective of this prospective study was to examine the...

  • miRNA-197 and miRNA-223 Predict Cardiovascular Death in a Cohort of Patients with Symptomatic Coronary Artery Disease. Schulte, Christian; Molz, Simon; Appelbaum, Sebastian; Karakas, Mahir; Ojeda, Francisco; Lau, Denise M.; Hartmann, Tim; Lackner, Karl J.; Westermann, Dirk; Schnabel, Renate B.; Blankenberg, Stefan; Zeller, Tanja // PLoS ONE;12/31/2015, Vol. 10 Issue 12, p1 

    Background: Circulating microRNAs (miRNAs) have been described as potential diagnostic biomarkers in cardiovascular disease and in particular, coronary artery disease (CAD). Few studies were undertaken to perform analyses with regard to risk stratification of future cardiovascular events....

  • Hypertension diagnosis failures.  // Pulse;10/12/2006, Vol. 66 Issue 38, p4 

    The article reports that patients at risk of stroke are insufficiently treated for hypertension due to failures in diagnostic practice, according to a new research. Patients with previous ischaemic attacks or minor strokes were found to suffer striking fluctuations in blood pressure in the...

  • Stress echocardiography for the diagnosis of ischaemia in hypertensives. Ariff, B; Thom, S AMcG; Foale, R A; Mayet, J // Journal of Human Hypertension;Jun2000, Vol. 14 Issue 6, p399 

    Exercise treadmill electrocardiography and myocardial perfusion imaging are commonly used in non-invasive tests for the detection of myocardial ischaemia. Unfortunately there are limitations in the assessment of hypertensive patients since these tests frequently provide false-positive results,...

  • ß-blockers: prescription rate less for African Americans and women.  // PharmacoEconomics & Outcomes News;6/3/2006, Issue 504, p7 

    Reports on a study on the benefits of ²-blockers for younger adults and patients with hypertension and with a previous ischaemic heart disorder. Methodology used by the researchers to complete the study; Findings of the study.

  • Perfil de pacientes submetidos à cirurgia de revascularização miocárdica: implicações para o cuidado de enfermagem. Fernandes, Michelle Villas Boas; Aliti, Graziella; Souza, Emiliane N. // Revista Eletronica de Enfermagem;2009, Vol. 11 Issue 4, p993 

    The severity of patients undergoing coronary artery bypass grafting (CABG) has increased considerably in recent decades. This contemporaneous cohort study aimed to evaluate the clinical and surgical profile of patients undergoing CABG. Data were retrieved from medical records of 58 inpatients in...

  • Methods to Develop an Electronic Medical Record Phenotype Algorithm to Compare the Risk of Coronary Artery Disease across 3 Chronic Disease Cohorts. Liao, Katherine P.; Ananthakrishnan, Ashwin N.; Kumar, Vishesh; Xia, Zongqi; Cagan, Andrew; Gainer, Vivian S.; Goryachev, Sergey; Chen, Pei; Savova, Guergana K.; Agniel, Denis; Churchill, Susanne; Lee, Jaeyoung; Murphy, Shawn N.; Plenge, Robert M.; Szolovits, Peter; Kohane, Isaac; Shaw, Stanley Y.; Karlson, Elizabeth W.; Cai, Tianxi // PLoS ONE;8/24/2015, Vol. 10 Issue 8, p1 

    Background: Typically, algorithms to classify phenotypes using electronic medical record (EMR) data were developed to perform well in a specific patient population. There is increasing interest in analyses which can allow study of a specific outcome across different diseases. Such a study in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics