Background: Although, there is a progressive decline in cardiovascular mortality in North America, West Europe,
Japan and Australasia, but most hypertensive subjects have imperfect control. In addition, the prevalence of hypertension
in Vietnam as well as in developing countries is notable increasing along with the total numbers of strokes and coronary
heart disease (CHD) events
Objective: The aim of this study is to determine the cardiovascular risk factors associated with hypertension and
the application of the new WHO/ISH guidelines on clinical practice at Khanh Hoa Province, Vietnam.
Subjects and Methods: Cross-sectional study, 258 hypertensive patients with age older than 60 (140 males and 118
females, mean age: 70.37±7.69) were defined according to the 1999 WHO/ISH criteria. Blood pressure was measured on the
right arm with a mercury sphygmomanometer by a physician or a trained nurse. All subjects were evaluated their risk
factors by a comprehensive clinical history and full clinical examination. An electrocardiogram at rest and blood samples
were obtained after an overnight fast and analyzed for total cholesterol, high-density lipoprotein cholesterol (HDL-C),
low-density lipoprotein cholesterol (LDL-C), triglycerides, glycemie, and creatinine. In case of total cholesterol >2g/l,
HDL-C > 35mg/dl, LDL-C >130mg/dl and glycemia >126mg/dl, a second blood sample was taken to define for the
hypercholesterolemia and diabetes mellitus. Assessment of risk level is calculated according to the criteria of 1999
Results: The prevalence of isolated systolic hypertension was 36.04 per cent. The mean summation of major risk
factors per individual was 1.5 ± 0.82 with 1.89 ± 0.81 (male) and 1.05 ±0.58 (female) P<0.001. The results of additional
risk factors were as followed: Hypercholesteroemia 49.41%. (10.89% >2.5g/l). Smoking: 29.45%. Diabetes mellitus: 21.17 %.
Family history of premature cardiovascular disease (CVD): 5.81 %. HDL-C < 35mg/dl: 51.51 %. LDL -C >130mg/dl: 46.66 %.
Obesity: 1.62 %. Overweight: 12.60 %. Left ventricular hypertrophy: 18.29 %. Microalbuminuria / diabetes 25.92 %.
Cerebrovascular disease: 10.07 %. Heart disease: 11.62 %. Renal disease: 3.48 %. Hypertension with grade 1: 35.82 %,
grade 2: 42.63 %, grade 3: 20.54 %. Compared with the number of risk factors in the International Nifedipine GITS Study:
Intervention as a Goal in Hypertension Treatment (INSIGHT) and the Antihypertensive Lipid Lowering Treatment to Prevent
Heart Attack Trial (ALLHAT), there was no significant difference. The rate of stratifying risk to quantify prognosis
(of the typical 10-year risk of stroke or myocardial infarction) with "Low- risk": 2.32 per cent, "Medium- risk": 39.62 %,
"High- risk": 25.96 %, " Very- high-risk": 41.08 %. The application of the current guidelines by local medical
practitioners was still very modest.
Conclusion: Cardiovascular risk assessment is an important addition to the doctor's diagnostic and prognostic
black bag. However, this study showed that there was little evidence that the clinical practice has improved following
release of guidelines. The guidelines were widely acknowledged but largely ignored. Therefore, we need to have univesary
guideline and the strategies to apply better theses guidelines for management of hypertension as well as of other risk
factors in clinical practice with optimal treatment to improve the quality of life of patient: live longer, live healthier,
Key words: cardiovascular, coronary heart disease, isolated systolic hypertension