| Objective This study aimed to investigate the atherosclerotic cardiovascular disease (ASCVD) risk stratification and target achievement of lipid and blood pressure control among community-based hypertensive patients,with the goal of optimizing integrated management strategies. Methods A total of 2832 hypertensive patients registered in 2021 at the Bicheng Community Health Service Center in Bishan District of Chongqing,were included.Baseline data were collected through retrospective analysis of health records.Non-high-density lipoprotein cholesterol (non-HDL-C) levels and estimated glomerular filtration rate (eGFR) were calculated. ASCVD risk stratification was performed, and target achievement for lipid and blood pressure control were analyzed, including comparisons among patients with different comorbidities.Results Based on ASCVD risk stratification, patients were categorized as follows: ultra-high risk (22 cases, 0.78%), very high risk (111 cases, 3.92%), high risk (1324 cases, 46.75%), moderate risk (997 cases, 35.20%), and low risk (378 cases, 13.35%). The LDL-C target achievement rate was 4.55% (1/22) in the ultra-high risk group and 15.32% (17/111) in the very high risk group, with blood pressure target achievement rate of 18.18% (4/22) and 11.71% (13/111),respectively.In the high-risk group, LDL-C and blood pressure target achievement rate were only 4.76% (63/1324) and 8.08% (107/1324), while moderate-risk groups showed 25.68% (256/997) and 26.18% (261/997), respectively.The low-risk group achieved 99.74% (377/378) LDL-C target achievement and 30.69% (116/378) blood pressure target achievement. Patients with ischemic stroke had a significantly higher lipid target achievement rate (13.73%, 7/51) compared to non-ischemic stroke patients (6.40%, 178/2781)(P<0.05). Similarly,those with coronary heart disease (12.65%,13/87) exhibited higher lipid target achievement than non-coronary heart disease patients (6.27%,172/2745)(P<0.05). However, no significant difference was observed between hypertensive patients with diabetes (8.04%,52/647) and non-diabetic patients (6.09%, 133/2185)(P＞0.05), or between those with chronic kidney disease (CKD) stages 3/4 (6.72%,16/238) and non-CKD 3/4 patients (6.52%,169/2594)(P＞0.05).Conclusion Over half of the community-based hypertensive patients were classified as high-risk or above in ASCVD stratification,yet their lipid and blood pressure target achievement rates were markedly suboptimal. Hypertension patients with comorbidities, particularly diabetes or CKD stages 3/4, showed poor lipid target achievement. These findings underscore the necessity of incorporating ASCVD risk stratification into community management assessments for hypertensive patients, enhancing personalized management for high-risk populations, and prioritizing lipid target achievement in those with diabetes or CKD stages 3/4. |
