Cardiovascular risk assessment and risk factor control in patients with hypertension in Europe: the SNAPSHOT study

Underestimated cardiovascular (CV) risk may lead to inadequate control of blood pressure (BP), LDL cholesterol, and glycated haemoglobin. This study investigated CV risk assessment and BP, LDL cholesterol, and glycated haemoglobin control among patients with hypertension in routine clinical practice.

In the observational, cross-sectional, epidemiological SNAPSHOT study (conducted in Bulgaria, Croatia, Georgia, Romania, Serbia, and Spain), CV risk was assessed in adults with hypertension according to the physician clinical practices, guidelines, and the risk assessment models valid when the study was performed (SCORE1 and SCORE2/SCORE2-OP). Blood pressure, LDL cholesterol, and glycated haemoglobin control rates were also assessed. Of 9307 patients (aged 65.8 ± 10.5 years, 43.1% male), most (91.3%) had ≥1 additional CV risk factor; 7610 (81.8%) had dyslipidaemia and 3097 (33.3%) had type 2 diabetes (T2D). Compared with guideline recommendations, assessment of patient CV risk by physicians, relative to the risk obtained using SCORE1 and SCORE2/SCORE2-OP, was accurate in only 38.0 and 26.7% of patients, respectively, and was underestimated in 54.3 and 71.8% of patients. Control rates of BP, LDL cholesterol, and glycated haemoglobin were suboptimal [<25%, <12% (in those with comorbid dyslipidaemia), and <50% (in those with comorbid T2D), respectively].

Physicians from six European countries tended to overestimate control rates of BP and LDL cholesterol, while underestimating CV risk in their patients with hypertension. Overall, BP, LDL cholesterol, and glycated haemoglobin control rates were low. Better implementation of clinical guideline recommendations is needed.