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High remaining risk in poorly treated hypertension: the 'rule of halves' still exists

Lars Weinehall1, Bengt Ohgren, Mats Persson

  • 1Epidemiology, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. Lars.Weinehall@epiph.umu.se

Journal of Hypertension
|October 3, 2002
PubMed

Insights

Poorly controlled or untreated hypertension significantly increases stroke risk, highlighting a need for better blood pressure management. Many individuals with high blood pressure in Sweden still lack optimal care, posing a notable health concern.

Area of Science:

  • Cardiovascular Epidemiology
  • Public Health
  • Hypertension Management

Background:

  • Stroke remains a leading cause of disability and mortality worldwide.
  • Effective management of hypertension is crucial for primary stroke prevention.
  • Understanding risk factor distribution and treatment effectiveness in specific populations is vital.

Purpose of the Study:

  • To identify risk factors for first-ever stroke events.
  • To assess the association between different hypertension categories and stroke risk.
  • To determine the prevalence of these hypertension categories in a defined Swedish population.

Main Methods:

  • A population-based study combining cross-sectional and incident case-control designs.
  • Inclusion of 59,735 participants for cross-sectional analysis and 129 stroke cases with controls for case-control analysis.
  • Categorization of blood pressure status including normotensive, treated/controlled hypertension, treated/uncontrolled hypertension, and untreated hypertension.

Main Results:

  • In the cross-sectional cohort, 16% had newly detected high blood pressure, and 7% had untreated hypertension.
  • Univariate analysis showed diabetes, smoking, obesity, and poorly controlled/untreated hypertension increased stroke risk.
  • Multivariate analysis confirmed significant stroke risk associated with poorly controlled (OR 6.1) and untreated hypertension (OR 4.3), and diabetes.

Conclusions:

  • Adequate blood pressure control is essential for reducing stroke risk.
  • A significant proportion of hypertensive individuals in Sweden receive suboptimal care, perpetuating the 'rule of halves'.
  • The high residual stroke risk in inadequately treated hypertensive patients necessitates urgent medical attention and improved public health strategies.
Abstract

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