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Multimorbidity and blood pressure control in 37 651 hypertensive patients from Danish general practice

Maja S Paulsen1, Morten Andersen, Janus L Thomsen

  • 1Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark. mspaulsen@health.sdu.dk

Journal of the American Heart Association
|March 26, 2013
PubMed

Insights

Blood pressure control in hypertensive patients is low, especially for those with diabetes. However, serious comorbidities like heart failure did not lower, and sometimes improved, blood pressure control rates in primary care.

Area of Science:

  • Cardiology
  • General Practice
  • Public Health

Background:

  • Hypertension management is primarily in general practice, yet major studies often exclude primary care populations.
  • Limited data exists on blood pressure control rates in hypertensive patients with diabetes and/or cardiovascular diseases (CVDs).
  • Investigating the impact of comorbidities on blood pressure control is crucial for effective hypertension management.

Purpose of the Study:

  • To examine the association between comorbidities and blood pressure control in a large cohort of hypertensive patients.
  • To assess blood pressure control rates in primary care settings for patients with various comorbidities.

Main Methods:

  • Utilized the Danish General Practice Database, including 37,651 hypertensive patients from 231 general practices.
  • Defined blood pressure (BP) control as <140/90 mm Hg generally, and <130/80 mm Hg for patients with diabetes.
  • Analyzed control rates based on the presence of diabetes, CVDs, heart failure, and asthma.

Main Results:

  • Overall blood pressure control rate was 33.2%.
  • Only 16.5% of patients with diabetes achieved target blood pressure.
  • Patients with ischemic heart disease or cerebrovascular/peripheral vascular disease had control rates of 42.9%–51.4%.
  • Comorbidities like heart failure and asthma were associated with higher, not lower, blood pressure control rates in certain patient groups.

Conclusions:

  • In Danish general practice, only one-third of hypertensive patients achieved their blood pressure target.
  • Blood pressure control rates vary significantly among patients with different comorbidities.
  • Serious comorbidities, beyond diabetes and/or CVD, did not negatively impact blood pressure control and sometimes improved it.
Abstract

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