Implications for medical activity of differences between individuals with controlled and uncontrolled hypertension

To compare clinical characteristics, medical activity, and family and social characteristics of individuals with controlled and uncontrolled hypertension.

This was an observational study on an alphabetically organized randomized sample of individuals suffering from hypertension in a primary care setting followed by 25 general practitioners at three clinics in the Central region of Portugal in mid-2018. Electronic medical records of individuals with an ICPC-2 classification of hypertension were analyzed. Epidemiologic, family, social and therapeutic data were gathered for descriptive and inferential analysis.

From a total population of 8750 patients classified as having hypertension, a representative sample of 387 individuals (n=369 required for a 95% confidence interval and 5% error margin) was studied. The incidence of uncontrolled hypertension was 56.1%, significantly higher among those living alone (p=00.24) or in a nuclear family (p=0.011), in lower socioeconomic classes (p=0.018), and prescribed anti-inflammatory drugs (p=0.018). The calculated cardiovascular risk was no higher for uncontrolled hypertension (p=0.116). Therapeutic inertia was not found either in number of medicines or in their association (p=0.274). No other studied variables showed a significant difference. Binary logistic regression revealed that living alone or in a nuclear family, and in a family with low socioeconomic level, were associated with uncontrolled hypertension, this model representing 9.6% of the likelihood of having uncontrolled hypertension.

Medical activity in general practice and other settings should, in the light of these findings, ally therapeutic competencies with knowledge gained from studying individual, family and social characteristics in order to improve blood pressure control.