Related Experiment Video
Updated: Oct 11, 2025
Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
Blood pressure and cholesterol measurements in primary care: cross-sectional analyses in a dynamic cohort
Annemarijn R de Boer1,2, Monika Hollander3, Ineke van Dis2
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands a.r.deboer-9@umcutrecht.nl.
Insights
Cardiovascular risk management (CVRM) guideline implementation shows adequate blood pressure (BP) and cholesterol measurement rates in primary care. However, CVRM can be improved, particularly for patients without a specific cardiovascular risk assessment indication.
Area of Science:
- Primary Care Research
- Cardiovascular Disease Prevention
- Health Services Research
Background:
- Cardiovascular risk management (CVRM) guidelines recommend periodic blood pressure (BP) and cholesterol measurements for at-risk populations.
- Specific age and sex criteria (men ≥40 years, women ≥50 years) are outlined for these essential health screenings.
Purpose of the Study:
- To evaluate the implementation of CVRM guidelines in primary care settings.
- To assess trends in BP and cholesterol measurement frequency over a decade (2008-2018).
Main Methods:
- Utilized dynamic cohort analysis of electronic health record (EHR) data from the Julius General Practitioners' Network (JGPN).
- Examined measurement frequencies (BP and cholesterol) at 1, 2, and 5-year intervals across different patient risk groups.
- Employed logistic regression mixed-model analyses to assess temporal trends.
Main Results:
- Annual BP and cholesterol measurements increased significantly for patients with a history of cardiovascular disease (CVD).
- Between 2014-2018, 74-82% of eligible men and women received both BP and cholesterol measurements within a 5-year period.
- Patients without a specific cardiovascular risk assessment (CRA) indication had the lowest measurement rates.
Conclusions:
- Primary care EHR data suggest adequate implementation of CVRM guidelines regarding measurement frequency.
- Despite overall adequate rates, opportunities exist to enhance CVRM, especially for individuals without a clear CRA indication.
- The 5-year primary care visit window provides a substantial opportunity to improve CVRM for all eligible patients.
Background:
Guidelines on cardiovascular risk management (CVRM) recommend blood pressure (BP) and cholesterol measurements every 5 years in men aged ≥40 years and (post-menopausal) women aged ≥50 years.
Aim:
To evaluate CVRM guideline implementation.
Design & Setting:
Cross-sectional analyses in a dynamic cohort using primary care electronic health record (EHR) data from the Julius General Practitioners' Network (JGPN) (n = 388 929).
Method:
Trends (2008-2018) were assessed in the proportion of patients with at least one measurement (BP and cholesterol) every 1, 2, and 5 years, in those with:1. a history of cardiovascular disease (CVD) and diabetes mellitus (DM);2. a history of DM only;3. a history of CVD only;4. a cardiovascular risk assessment (CRA) indication based on other medical history, or;5. no CRA indication.Trends were evaluated over time using logistic regression mixed-model analyses.
Results:
Trends in annual BP and cholesterol measurement increased for patients with a history of CVD from 37.0% to 48.4% (P<0.001) and 25.8% to 40.2% (P<0.001). In the 5-year window from 2014-2018, BP and cholesterol measurements were performed respectively in 78.5% and 74.1% of all men aged ≥40 years and 82.2% and 78.5% of all women aged ≥50 years. Least measured were patients without a CRA indication (men 60.2% and 62.4%; women 55.5% and 59.3%).
Conclusion:
The fairly high frequency of CVRM measurements available in the EHR of patients in primary care suggests an adequate implementation of the CVRM guideline. As nearly all individuals visit the GP at least once within a 5-year time window, improvement of CVRM remains possible, especially in those without a CRA indication.
Related Concept Videos
01:28Factors affecting Blood pressure
Physiological Factors:
01:25Errors occurring during blood pressure monitoring
Several factors...
01:17Measurement of Blood Pressure
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:23Assessment of blood pressure in brachial artery(two-step method)