Literature DB >> 31397682

Is the rule of halves still relevant today? A cross-sectional analysis of hypertension detection, treatment and control in an urban community.

Alice S Wu1, Hiten Dodhia, David Whitney, Mark Ashworth.   

Abstract

AIMS: To estimate percentages of patients with undiagnosed hypertension, diagnosed untreated hypertension and diagnosed, treated and uncontrolled hypertension and to identify sociodemographic factors for diagnosed, uncontrolled hypertension and not having a blood pressure (BP) reading recorded.
METHODS: Data from 320 094 patients aged 18 to less than 80 years from general practices in inner London was analysed using both last recorded BP (blood pressure) and mean BP. Logistic regression models identified factors associated with uncontrolled hypertension and no recorded BP.
RESULTS: Twenty-nine thousand, seven hundred and nineteen (9.3%) patients had a recorded diagnosis of hypertension. On the basis of analysis of the last BP value, 14.2% (n = 4207) were untreated and 46.3% (n = 13 749) had uncontrolled hypertension; 10.0% (n = 28 274) without a prior hypertension diagnosis had undiagnosed hypertension. Corresponding values based on mean BP analysis were 8.9% (n = 2367) untreated, 51.5% (n = 13 734) uncontrolled; 4.1% (n = 11 446) undiagnosed. 17.5% (n = 55 960) had no recorded BP value.Black ethnicity was a predictor of uncontrolled hypertension: compared with the White British population, the adjusted odds ratio (AOR) for the Black African population was 1.39 (95% CI: 1.25-1.53) and for the Black Caribbean was 1.31 (95% CI: 1.19-1.45). The White Other group were most likely to have no record of BP measurement (AOR: 1.52; 95% CI: 1.47-1.57); conversely, unrecorded BP was less likely in the Black African (AOR: 0.79; CI: 0.74-0.83) and Black Caribbean (AOR: 0.71; CI: 0.66-0.76) groups, relative to the White British population.
CONCLUSION: In an inner-city, multiethnic population, the 'rule of halves' still broadly applies to the diagnosis and control of hypertension, although only a small proportion were untreated.

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Mesh:

Year:  2019        PMID: 31397682     DOI: 10.1097/HJH.0000000000002192

Source DB:  PubMed          Journal:  J Hypertens        ISSN: 0263-6352            Impact factor:   4.844


  7 in total

1.  Uncoded chronic kidney disease in primary care: a cross-sectional study of inequalities and cardiovascular disease risk management.

Authors:  Mariam Molokhia; Grace N Okoli; Patrick Redmond; Elham Asgari; Catriona Shaw; Peter Schofield; Mark Ashworth; Stevo Durbaba; Dorothea Nitsch
Journal:  Br J Gen Pract       Date:  2020-10-29       Impact factor: 5.386

2.  Rapid treatment of moderate to severe hypertension using a novel protocol in a single-centre, before and after interventional study.

Authors:  Andrew N Jordan; Christine Anning; Lindsay Wilkes; Claire Ball; Nicola Pamphilon; Christopher E Clark; Nicholas G Bellenger; Angela C Shore; Andrew S P Sharp
Journal:  J Hum Hypertens       Date:  2019-10-23       Impact factor: 3.012

3.  What factors influence differential uptake of NHS Health Checks, diabetes and hypertension reviews among women in ethnically diverse South London? Cross-sectional analysis of 63,000 primary care records.

Authors:  Mariam Molokhia; Dr Salma Ayis; Alexis Karamanos; Dr Veline L'Esperance; Sarah Yousif; Stevo Durbaba; Vasa Ćurčin; Mark Ashworth; Seeromanie Harding
Journal:  EClinicalMedicine       Date:  2022-05-27

4.  Equity, a common goal for primary care.

Authors:  Sally A Hull; Kambiz Boomla; Carol Dezateux; John Robson
Journal:  Br J Gen Pract       Date:  2021-04-29       Impact factor: 5.386

5.  Inequalities in developing multimorbidity over time: A population-based cohort study from an urban, multi-ethnic borough in the United Kingdom.

Authors:  Alessandra Bisquera; Ellie Bragan Turner; Lesedi Ledwaba-Chapman; Rupert Dunbar-Rees; Nasrin Hafezparast; Martin Gulliford; Stevo Durbaba; Marina Soley-Bori; Julia Fox-Rushby; Hiten Dodhia; Mark Ashworth; Yanzhong Wang
Journal:  Lancet Reg Health Eur       Date:  2021-11-04

6.  Variation in appropriate diabetes care and treatment targets in urban and rural areas in England: an observational study of the 'rule of halves'.

Authors:  Thomas Mason; William Whittaker; Jo C Dumville; Peter Bower
Journal:  BMJ Open       Date:  2022-02-16       Impact factor: 2.692

7.  Determinants of long-term opioid prescribing in an urban population: A cross-sectional study.

Authors:  Michael Naughton; Patrick Redmond; Stevo Durbaba; Mark Ashworth; Mariam Molokhia
Journal:  Br J Clin Pharmacol       Date:  2022-02-07       Impact factor: 3.716

  7 in total

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