Factors associated with blood pressure control in Swedish primary care patients with hypertension: a cross-sectional study
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Published on: May 3, 2018
Niklas Brodin1,2, Moa Wolff1,2, Beata Borgström Bolmsjö1,2
1Office for Primary Care, Skåne University Hospital, Malmö, Sweden.
Insights
Achieving blood pressure control is possible with multiple medications, especially for patients with myocardial infarction or diabetes. A family history of hypertension, however, was linked to poorer blood pressure management.
Area of Science:
- Cardiology
- Primary Healthcare
- Hypertension Management
Background:
- Hypertension affects a significant portion of the primary healthcare population.
- Effective blood pressure control is crucial for preventing cardiovascular complications.
- Current treatment guidelines often recommend combination therapy for optimal hypertension management.
Purpose of the Study:
- To identify factors associated with achieving blood pressure control (<140/90 mmHg) in a primary healthcare setting.
- To analyze the impact of comorbidities, medication use, and family history on hypertension management.
Main Methods:
- Utilized baseline data from a Swedish randomized controlled trial involving 400 hypertensive patients.
- Collected data through blood pressure measurements, blood sampling, and questionnaires on lifestyle and medical history.
- Employed logistic regression to determine odds ratios (OR) and 95% confidence intervals (CI) for factors influencing blood pressure control.
Main Results:
- Blood pressure control was achieved in 41% of the participants (mean age 69 years).
- Factors positively associated with blood pressure control included previous myocardial infarction (OR 2.44) and diabetes diagnosis (OR 2.26).
- Using two or more blood pressure medications (OR 1.62) also correlated with better control, while a family history of hypertension showed a negative association (OR 0.29).
Conclusions:
- The study highlights a significant association between using multiple antihypertensive medications and achieving blood pressure control.
- Despite guidelines, single-drug therapy remains prevalent; combination therapy could improve control rates.
- Targeting patients with a family history of hypertension and those without comorbidities for intensified management may further enhance blood pressure control outcomes.
Purpose:
This study aimed to investigate the factors associated with blood pressure control in a primary healthcare population with hypertension.
Materials And Methods:
We used baseline data from a recent Swedish randomized controlled trial where 400 patients diagnosed with hypertension from 10 primary health care centers were included. The participants underwent blood pressure measurements, blood sampling and completed questionnaires on quality of life, physical activities, tobacco- and alcohol use, medication, and comorbidities. Logistic regression analyses were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with blood pressure control (<140/90 mmHg).
Results:
The mean age of the participants was 69 years. The results showed blood pressure control in 41% of the cases. The factors that had the highest ORs for achieving blood pressure control were previous myocardial infarction (OR 2.44; CI 1.08-5.53), diabetes diagnosis (OR 2.26; CI 1.31-3.88), and use of ≥2 blood pressure medications (OR 1.62; CI 1.07-2.46). Family history of hypertension was negatively associated with blood pressure control (OR 0.29; CI 0.38-0.88) (univariate analyses).
Conclusions:
Our study found an association between the use of ≥2 antihypertensive medications and blood pressure control. Despite current treatment guidelines for hypertension, the use of single-drug therapy remains common. By shifting from single drug to combination therapy, focusing on patients with a family history of hypertension and those without comorbidities, the proportion achieving blood pressure control could increase significantly.
Trial Registration:
ClinicalTrials.gov (NCT04407962).
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