Epidemiological, Clinical, and Biological Profile of Hypertensive Patients and Cardiovascular Risk Distribution according to ESC–ESH Guidelines: A Cross-Sectional Study

Abstract

Background: Hypertension is the most prevalent modifiable cardiovascular risk factor worldwide and a major driver of morbidity and mortality. In Morocco, prevalence is high and control rates remain suboptimal. Limited data exist applying the 2018 ESC–ESH cardiovascular risk (CVR) stratification to Moroccan hypertensive cohorts. Methods: We conducted a descriptive cross-sectional study (January 2020–December 2024) at the Hypertension Clinic of the Ibn Rochd University Hospital Centre, Casablanca. Adults (≥18 years) diagnosed with hypertension per ESC–ESH 2018 criteria were included. Sociodemographic, clinical, anthropometric, and laboratory data were collected. Global CVR was classified into low, moderate, high, or very high risk. Subgroup analyses were performed by sex, age, BMI category, and comorbidities. Results: The study included 226 patients (mean age 61.4 years, 80.1% women). Comorbidities included diabetes (29.2%), dyslipidemia (32.3%), and obesity (BMI ≥30 in 41.2%). Overall, 47.3% achieved BP control per ESC–ESH 2018 targets. BP control varied across risk categories: 58.5% in low risk, 52.3% in moderate risk, 46.2% in high risk, and only 41.0% in very high-risk groups. High/very high risk was more frequent in older patients, men, and those with obesity, diabetes, or hypertension-mediated organ damage. Conclusion: Most hypertensive patients in this Moroccan tertiary care setting fell into high or very high CVR categories, with fewer than half achieving guideline BP targets. These findings highlight the urgent need for intensified, risk-based management, integration of the 2024 ESC–ESH recommendations, and strengthened public health strategies to improve hypertension control nationwide.