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Hypertension prevalence, coding and control in an urban primary care setting in the UK between 2014 and 2021

Karol Basta1, Lesedi Ledwaba-Chapman2, Hiten Dodhia1

  • 1Lambeth Council Public Health, Civic Centre.

Journal of Hypertension
|October 5, 2023
PubMed

Insights

High rates of uncontrolled hypertension persist, particularly among men and Black individuals. Obesity and male sex predict uncoded elevated blood pressure, while Black ethnicity is linked to uncontrolled hypertension, necessitating targeted interventions.

Area of Science:

  • Cardiovascular Medicine
  • Public Health
  • Health Informatics

Background:

  • Hypertension remains a significant, preventable cause of mortality globally.
  • Existing health inequalities are exacerbated by factors like socioeconomic status and ethnicity, further complicated by the COVID-19 pandemic.
  • High rates of undiagnosed and uncontrolled hypertension persist, particularly in primary care settings.

Purpose of the Study:

  • To determine the prevalence of unmeasured blood pressure (BP), uncoded elevated BP, and uncontrolled hypertension.
  • To identify predictors associated with these hypertension outcomes in a primary care population.
  • To inform targeted interventions for improving hypertension management and control.

Main Methods:

  • A population-based cohort study utilizing anonymized primary care data from 41 general practices.
  • Inclusion of sociodemographic, lifestyle, and clinical factors for analysis.
  • Logistic regression modeling to identify associations between patient characteristics and hypertension outcomes, defined by NICE guidelines.

Main Results:

  • 39.5% of patients had unmeasured BP, with male sex and pandemic registration as key predictors.
  • 36.0% of adults with elevated BP were uncoded, with obesity and increasing age as significant predictors.
  • 46.8% of adults on the hypertension register had uncontrolled hypertension, with Black ethnicity and cardiovascular comorbidities as predictors.

Conclusions:

  • A substantial burden of uncoded elevated BP and uncontrolled hypertension exists within primary care.
  • Obesity, male sex, and Black ethnicity are significant predictors requiring focused attention.
  • Targeted initiatives are crucial to optimize hypertension coding and control, especially for vulnerable subgroups.
Abstract

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