Charlotte Holmquist1, Jan Hasselström, Kristina Bengtsson Boström, Karin Manhem, Björn Wettermark, Per Hjerpe, Thomas Kahan. 1. aDepartment of Neurobiology, Care Sciences and Society, Centre for Family Medicine, Karolinska Institutet, Stockholm bR&D Centre Skaraborg Primary Care, Skövde cDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital, Sahlgrenska Academy, University of Gothenburg, Gothenburg dDepartment of Medicine, Centre for Pharmacoepidemiology, Karolinska Institutet ePublic Healthcare Services Committee, Stockholm County Council fDivision of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Abstract
OBJECTIVE: To study temporal trends in hypertension treatment and control in Swedish primary care, in relation to clinical characteristics, comorbidity, and drug treatment. MATERIALS AND METHODS: Repeated cross-sectional analysis of 43 239 hypertensive patients attending primary care in 2001-2002 and of 62 407 patients in 2007-2008. RESULTS: Mean blood pressure (BP) 2007-2008 was 143/79 mmHg in women and 142/81 mmHg in men. Cardiovascular comorbidity and diabetes were present in 13 and 15% of women, and in 18 and 20% of men. Overall BP reductions from 2001-2002 to 2007-2008 were 9.0/3.1 mmHg; greater in women than men, with advancing age, and in patients with comorbidity (all P < 0.001). Attainment of target BP (<140/90 mmHg) increased from 24 and 26% in women and men (2001-2002) to 37 and 37% (2007-2008; all P < 0.001). Most common drug classes in 2001-2002 were, in descending frequency, β blockers, diuretics, and calcium channel blockers (both sexes), and in 2007-2008 β blockers, diuretics, and angiotensin-converting enzyme inhibitors in women, and β blockers, angiotensin-converting enzyme inhibitors, and diuretics in men. The number of drug classes/patient increased from 1.5 (2001-2002) to 1.8 (2007-2008; P < 0.001) but remained low (1.7) in those above target BP. CONCLUSION: BP control in hypertensive patients attending Swedish primary care has improved over 5-7 years, and more so in high-risk groups. There is, however, room for improvement. In uncontrolled hypertension the combination of several drug classes remain low.
OBJECTIVE: To study temporal trends in hypertension treatment and control in Swedish primary care, in relation to clinical characteristics, comorbidity, and drug treatment. MATERIALS AND METHODS: Repeated cross-sectional analysis of 43 239 hypertensivepatients attending primary care in 2001-2002 and of 62 407 patients in 2007-2008. RESULTS: Mean blood pressure (BP) 2007-2008 was 143/79 mmHg in women and 142/81 mmHg in men. Cardiovascular comorbidity and diabetes were present in 13 and 15% of women, and in 18 and 20% of men. Overall BP reductions from 2001-2002 to 2007-2008 were 9.0/3.1 mmHg; greater in women than men, with advancing age, and in patients with comorbidity (all P < 0.001). Attainment of target BP (<140/90 mmHg) increased from 24 and 26% in women and men (2001-2002) to 37 and 37% (2007-2008; all P < 0.001). Most common drug classes in 2001-2002 were, in descending frequency, β blockers, diuretics, and calcium channel blockers (both sexes), and in 2007-2008 β blockers, diuretics, and angiotensin-converting enzyme inhibitors in women, and β blockers, angiotensin-converting enzyme inhibitors, and diuretics in men. The number of drug classes/patient increased from 1.5 (2001-2002) to 1.8 (2007-2008; P < 0.001) but remained low (1.7) in those above target BP. CONCLUSION: BP control in hypertensivepatients attending Swedish primary care has improved over 5-7 years, and more so in high-risk groups. There is, however, room for improvement. In uncontrolled hypertension the combination of several drug classes remain low.
Authors: Mattias Ekström; Anna Hellman; Jan Hasselström; Camilla Hage; Thomas Kahan; Martin Ugander; Håkan Wallén; Hans Persson; Cecilia Linde Journal: ESC Heart Fail Date: 2020-02-19
Authors: Georgios Mourtzinis; Karin Manhem; Thomas Kahan; Linus Schiöler; Jetish Isufi; Charlotta Ljungman; Tobias Andersson; Per Hjerpe Journal: Scand J Prim Health Care Date: 2021-11-24 Impact factor: 2.581