Background: High-risk hypertensive patients often need immediate and more aggressive treatment to achieve adequate blood pressure (BP) control. There is currently no available Philippine data on the level of BP control and management specific to high-risk patients.

Objective: Primary Objective: To determine the prevalence of BP control in high-risk hypertensive patients.

Secondary Objectives:

1. To observe treatment pattern prescribed for high-risk hypertensive patients with uncontrolled BP.

2. To observe the change in BP after eight weeks of planned treatment modification.

Methods: This was a multicenter, observational disease registry of high-risk hypertensive patients based on the 2007 European Society of Hypertension/European Society of Cardiology guidelines. The study had two cross-sectional phases. Patient data, including level of BP control and any prescribed treatment modification, were collected on the first visit (V1). A second evaluation was done after eight weeks for patients with planned treatment modification (V2).

Results: In 804 patients with high-risk hypertension included in V1, only 37 patients (4.6%) had a baseline BP <130/80 mmHg. Treatment modification was planned in most patients by switching (352/804, 44%), adding antihypertensive agents (193/804, 24%) or increasing the treatment dose (33/804, 4.10%). Of the 325 patients with planned treatment modification evaluated at V2, 112 (34%) had no change in baseline treatment. After a mean treatment period of 5.66 weeks, there was a significant decrease from baseline in mean systolic (-23.95 mmHg) and diastolic (-9.26 mmHg) BP (both p<0.0001). Among patients followed-up, 90% (294/325) achieved target systolic or diastolic BP levels, while 70% (228/325) achieved both target systolic and diastolic BP levels at study completion.

Conclusion: BP control in high- risk hypertensive Filipinos is low. Most physicians modified treatment in patients with uncontrolled BP and this was effective in significantly lowering BP. However, larger trials based on current treatment guidelines for hypertension are needed to compare the relative benefits of different types of treatment modification.

Keywords: hypertension; blood pressure; high-risk; treatment modification

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