Variations in blood pressure and lipid goal attainment in primary care

Abstract

Background:
Hypertension and dyslipidemia are the most prevalent cardiovascular risk factors. Blood pressure (BP) and lipid levels are modifiable and yet most patients fail to achieve their recommended target goals. The objective of this review was to examine the variations in achievement of optimal BP and lipid levels in individuals with cardiovascular risk factors or cardiovascular disease at a primary care level.

Scope:
A comprehensive literature review and evaluation was conducted from January 2000 to June 2012 using electronic databases. The search was limited to studies reported in English language, published between January 2000 to June 2012 and those conducted in the US adult population (?18 years). The inclusion of articles was limited to populations with cardiovascular risk factors or any cardiovascular disease.

Findings:
The review identified a total of 32 studies that assessed variations in attainment of BP or lipid goals. The demographic factors (age, sex, and race) and clinical factors (obesity, presence of diabetes, and history of cardiovascular conditions) were most commonly evaluated by the studies. However, modifiable factors such as diet, physical exercise, adherence to medication, or smoking habit were least commonly evaluated by the studies documented in this review.

Conclusion:
The studies, conducted in a range of settings, reflect disparities in attainment of recommended BP or lipid goals. Given such disparities, future research is required to better understand the complexity of different factors underlying the failure of patients to achieve BP and lipid goals. This can help to identify appropriate treatment strategies or interventions that can address patient-specific needs at a primary care level.