Multimorbidity and Blood Pressure Control in 37 651 Hypertensive Patients From Danish General Practice
Background Patients with hypertension are primarily treated in general practice. However, major studies of patients with hypertension are rarely based on populations from primary care. Knowledge of blood pressure (BP) control rates in patients with diabetes and/or cardiovascular diseases (CVDs), who...
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| Veröffentlicht in: | Journal of the American Heart Association 2013-02, Vol.2 (1), p.e004531-n/a |
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| creator | Paulsen, Maja S. Andersen, Morten Thomsen, Janus L. Schroll, Henrik Larsen, Pia V. Lykkegaard, Jesper Jacobsen, Ib A. Larsen, Mogens L. Christensen, Bo Sondergaard, Jens |
| description | Background
Patients with hypertension are primarily treated in general practice. However, major studies of patients with hypertension are rarely based on populations from primary care. Knowledge of blood pressure (BP) control rates in patients with diabetes and/or cardiovascular diseases (CVDs), who have additional comorbidities, is lacking. We aimed to investigate the association of comorbidities with BP control using a large cohort of hypertensive patients from primary care practices.
Methods and Results
Using the Danish General Practice Database, we included 37 651 patients with hypertension from 231 general practices in Denmark. Recommended BP control was defined as BP |
| doi_str_mv | 10.1161/JAHA.112.004531 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3603256</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1319616450</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4383-1c077d6f8f657defbe84af3de5eebf119a1c9265358f3f37de273e3b5d4e92733</originalsourceid><addsrcrecordid>eNqFkU9P7CAUxYl5Ro26dmdYuhmF3kLbjcm88c_4otGFrgltL4ppYR60mvk2fhY_mUxGjW_12HAIP8495BBywNkx55Kf_JnOp0llx4zlAvgG2clYXkyqqmS_fuhtsh_jM0tLZgWIaotsZyAykXO-Qx5vxm6wvQ-1be2wpNq19HfnfUvvAsY4BqQz74bgO2odheL9TQpO58sFhgFdtC9I7_Rg0Q2RXgTf0zPtbHyil-gw6C656GawDe6RTaO7iPuf-y55uDi_n80n17eXV7Pp9aTJoYQJb1hRtNKURoqiRVNjmWsDLQrE2nBead5UmRQgSgMGEpK-hFCLNscqSdglp2vfxVj32DYpWIqhFsH2OiyV11b9e-Psk3r0Lwokg0zIZHD0aRD83xHjoHobG-w67dCPUXHgleQyFyyhJ2u0CT7GgOZ7DGdq1ZBaNZRUptYNpReHP9N98199JCBfA6-2w-X__Fbn5ArwAc1DnSQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1319616450</pqid></control><display><type>article</type><title>Multimorbidity and Blood Pressure Control in 37 651 Hypertensive Patients From Danish General Practice</title><source>MEDLINE</source><source>Wiley Online Library Open Access</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Paulsen, Maja S. ; Andersen, Morten ; Thomsen, Janus L. ; Schroll, Henrik ; Larsen, Pia V. ; Lykkegaard, Jesper ; Jacobsen, Ib A. ; Larsen, Mogens L. ; Christensen, Bo ; Sondergaard, Jens</creator><creatorcontrib>Paulsen, Maja S. ; Andersen, Morten ; Thomsen, Janus L. ; Schroll, Henrik ; Larsen, Pia V. ; Lykkegaard, Jesper ; Jacobsen, Ib A. ; Larsen, Mogens L. ; Christensen, Bo ; Sondergaard, Jens</creatorcontrib><description>Background
Patients with hypertension are primarily treated in general practice. However, major studies of patients with hypertension are rarely based on populations from primary care. Knowledge of blood pressure (BP) control rates in patients with diabetes and/or cardiovascular diseases (CVDs), who have additional comorbidities, is lacking. We aimed to investigate the association of comorbidities with BP control using a large cohort of hypertensive patients from primary care practices.
Methods and Results
Using the Danish General Practice Database, we included 37 651 patients with hypertension from 231 general practices in Denmark. Recommended BP control was defined as BP <140/90 mm Hg in general and <130/80 mm Hg in patients with diabetes. The overall control rate was 33.2% (95% CI: 32.7 to 33.7). Only 16.5% (95% CI: 15.8 to 17.3) of patients with diabetes achieved BP control, whereas control rates ranged from 42.9% to 51.4% for patients with ischemic heart diseases or cerebrovascular or peripheral vascular diseases. A diagnosis of cardiac heart failure in addition to diabetes and/or CVD was associated with higher BP control rates, compared with men and women having only diabetes and/or CVD. A diagnosis of asthma in addition to diabetes and CVD was associated with higher BP control rates in men.
Conclusion
In Danish general practice, only 1 of 3 patients diagnosed with hypertension had a BP below target. BP control rates differ substantially within comorbidities. Other serious comorbidities in addition to diabetes and/or CVD were not associated with lower BP control rates; on the contrary, in some cases the BP control rates were higher when the patient was diagnosed with other serious comorbidities in addition to diabetes and/or CVD.</description><identifier>ISSN: 2047-9980</identifier><identifier>EISSN: 2047-9980</identifier><identifier>DOI: 10.1161/JAHA.112.004531</identifier><identifier>PMID: 23525411</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Antihypertensive Agents - therapeutic use ; Asthma - epidemiology ; Blood Pressure - drug effects ; cardiovascular diseases ; Cerebrovascular Disorders - epidemiology ; comorbidities ; Comorbidity ; Cross-Sectional Studies ; Denmark - epidemiology ; Diabetes Mellitus - epidemiology ; Female ; General Practice ; Heart Failure - epidemiology ; Humans ; hypertension ; Hypertension - diagnosis ; Hypertension - drug therapy ; Hypertension - epidemiology ; Hypertension - physiopathology ; Logistic Models ; Male ; Middle Aged ; Myocardial Ischemia - epidemiology ; Odds Ratio ; Original Research ; Peripheral Vascular Diseases - epidemiology ; primary care ; Primary Health Care ; Registries ; Risk Factors ; Treatment Outcome</subject><ispartof>Journal of the American Heart Association, 2013-02, Vol.2 (1), p.e004531-n/a</ispartof><rights>2012 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley‐Blackwell.</rights><rights>2013 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley-Blackwell. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4383-1c077d6f8f657defbe84af3de5eebf119a1c9265358f3f37de273e3b5d4e92733</citedby><cites>FETCH-LOGICAL-c4383-1c077d6f8f657defbe84af3de5eebf119a1c9265358f3f37de273e3b5d4e92733</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603256/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603256/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,11541,27901,27902,46027,46451,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23525411$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paulsen, Maja S.</creatorcontrib><creatorcontrib>Andersen, Morten</creatorcontrib><creatorcontrib>Thomsen, Janus L.</creatorcontrib><creatorcontrib>Schroll, Henrik</creatorcontrib><creatorcontrib>Larsen, Pia V.</creatorcontrib><creatorcontrib>Lykkegaard, Jesper</creatorcontrib><creatorcontrib>Jacobsen, Ib A.</creatorcontrib><creatorcontrib>Larsen, Mogens L.</creatorcontrib><creatorcontrib>Christensen, Bo</creatorcontrib><creatorcontrib>Sondergaard, Jens</creatorcontrib><title>Multimorbidity and Blood Pressure Control in 37 651 Hypertensive Patients From Danish General Practice</title><title>Journal of the American Heart Association</title><addtitle>J Am Heart Assoc</addtitle><description>Background
Patients with hypertension are primarily treated in general practice. However, major studies of patients with hypertension are rarely based on populations from primary care. Knowledge of blood pressure (BP) control rates in patients with diabetes and/or cardiovascular diseases (CVDs), who have additional comorbidities, is lacking. We aimed to investigate the association of comorbidities with BP control using a large cohort of hypertensive patients from primary care practices.
Methods and Results
Using the Danish General Practice Database, we included 37 651 patients with hypertension from 231 general practices in Denmark. Recommended BP control was defined as BP <140/90 mm Hg in general and <130/80 mm Hg in patients with diabetes. The overall control rate was 33.2% (95% CI: 32.7 to 33.7). Only 16.5% (95% CI: 15.8 to 17.3) of patients with diabetes achieved BP control, whereas control rates ranged from 42.9% to 51.4% for patients with ischemic heart diseases or cerebrovascular or peripheral vascular diseases. A diagnosis of cardiac heart failure in addition to diabetes and/or CVD was associated with higher BP control rates, compared with men and women having only diabetes and/or CVD. A diagnosis of asthma in addition to diabetes and CVD was associated with higher BP control rates in men.
Conclusion
In Danish general practice, only 1 of 3 patients diagnosed with hypertension had a BP below target. BP control rates differ substantially within comorbidities. Other serious comorbidities in addition to diabetes and/or CVD were not associated with lower BP control rates; on the contrary, in some cases the BP control rates were higher when the patient was diagnosed with other serious comorbidities in addition to diabetes and/or CVD.</description><subject>Adult</subject><subject>Aged</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Asthma - epidemiology</subject><subject>Blood Pressure - drug effects</subject><subject>cardiovascular diseases</subject><subject>Cerebrovascular Disorders - epidemiology</subject><subject>comorbidities</subject><subject>Comorbidity</subject><subject>Cross-Sectional Studies</subject><subject>Denmark - epidemiology</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Female</subject><subject>General Practice</subject><subject>Heart Failure - epidemiology</subject><subject>Humans</subject><subject>hypertension</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - drug therapy</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - physiopathology</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Ischemia - epidemiology</subject><subject>Odds Ratio</subject><subject>Original Research</subject><subject>Peripheral Vascular Diseases - epidemiology</subject><subject>primary care</subject><subject>Primary Health Care</subject><subject>Registries</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><issn>2047-9980</issn><issn>2047-9980</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNqFkU9P7CAUxYl5Ro26dmdYuhmF3kLbjcm88c_4otGFrgltL4ppYR60mvk2fhY_mUxGjW_12HAIP8495BBywNkx55Kf_JnOp0llx4zlAvgG2clYXkyqqmS_fuhtsh_jM0tLZgWIaotsZyAykXO-Qx5vxm6wvQ-1be2wpNq19HfnfUvvAsY4BqQz74bgO2odheL9TQpO58sFhgFdtC9I7_Rg0Q2RXgTf0zPtbHyil-gw6C656GawDe6RTaO7iPuf-y55uDi_n80n17eXV7Pp9aTJoYQJb1hRtNKURoqiRVNjmWsDLQrE2nBead5UmRQgSgMGEpK-hFCLNscqSdglp2vfxVj32DYpWIqhFsH2OiyV11b9e-Psk3r0Lwokg0zIZHD0aRD83xHjoHobG-w67dCPUXHgleQyFyyhJ2u0CT7GgOZ7DGdq1ZBaNZRUptYNpReHP9N98199JCBfA6-2w-X__Fbn5ArwAc1DnSQ</recordid><startdate>201302</startdate><enddate>201302</enddate><creator>Paulsen, Maja S.</creator><creator>Andersen, Morten</creator><creator>Thomsen, Janus L.</creator><creator>Schroll, Henrik</creator><creator>Larsen, Pia V.</creator><creator>Lykkegaard, Jesper</creator><creator>Jacobsen, Ib A.</creator><creator>Larsen, Mogens L.</creator><creator>Christensen, Bo</creator><creator>Sondergaard, Jens</creator><general>Blackwell Publishing Ltd</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201302</creationdate><title>Multimorbidity and Blood Pressure Control in 37 651 Hypertensive Patients From Danish General Practice</title><author>Paulsen, Maja S. ; Andersen, Morten ; Thomsen, Janus L. ; Schroll, Henrik ; Larsen, Pia V. ; Lykkegaard, Jesper ; Jacobsen, Ib A. ; Larsen, Mogens L. ; Christensen, Bo ; Sondergaard, Jens</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4383-1c077d6f8f657defbe84af3de5eebf119a1c9265358f3f37de273e3b5d4e92733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Asthma - epidemiology</topic><topic>Blood Pressure - drug effects</topic><topic>cardiovascular diseases</topic><topic>Cerebrovascular Disorders - epidemiology</topic><topic>comorbidities</topic><topic>Comorbidity</topic><topic>Cross-Sectional Studies</topic><topic>Denmark - epidemiology</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Female</topic><topic>General Practice</topic><topic>Heart Failure - epidemiology</topic><topic>Humans</topic><topic>hypertension</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - drug therapy</topic><topic>Hypertension - epidemiology</topic><topic>Hypertension - physiopathology</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Ischemia - epidemiology</topic><topic>Odds Ratio</topic><topic>Original Research</topic><topic>Peripheral Vascular Diseases - epidemiology</topic><topic>primary care</topic><topic>Primary Health Care</topic><topic>Registries</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Paulsen, Maja S.</creatorcontrib><creatorcontrib>Andersen, Morten</creatorcontrib><creatorcontrib>Thomsen, Janus L.</creatorcontrib><creatorcontrib>Schroll, Henrik</creatorcontrib><creatorcontrib>Larsen, Pia V.</creatorcontrib><creatorcontrib>Lykkegaard, Jesper</creatorcontrib><creatorcontrib>Jacobsen, Ib A.</creatorcontrib><creatorcontrib>Larsen, Mogens L.</creatorcontrib><creatorcontrib>Christensen, Bo</creatorcontrib><creatorcontrib>Sondergaard, Jens</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the American Heart Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Paulsen, Maja S.</au><au>Andersen, Morten</au><au>Thomsen, Janus L.</au><au>Schroll, Henrik</au><au>Larsen, Pia V.</au><au>Lykkegaard, Jesper</au><au>Jacobsen, Ib A.</au><au>Larsen, Mogens L.</au><au>Christensen, Bo</au><au>Sondergaard, Jens</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multimorbidity and Blood Pressure Control in 37 651 Hypertensive Patients From Danish General Practice</atitle><jtitle>Journal of the American Heart Association</jtitle><addtitle>J Am Heart Assoc</addtitle><date>2013-02</date><risdate>2013</risdate><volume>2</volume><issue>1</issue><spage>e004531</spage><epage>n/a</epage><pages>e004531-n/a</pages><issn>2047-9980</issn><eissn>2047-9980</eissn><abstract>Background
Patients with hypertension are primarily treated in general practice. However, major studies of patients with hypertension are rarely based on populations from primary care. Knowledge of blood pressure (BP) control rates in patients with diabetes and/or cardiovascular diseases (CVDs), who have additional comorbidities, is lacking. We aimed to investigate the association of comorbidities with BP control using a large cohort of hypertensive patients from primary care practices.
Methods and Results
Using the Danish General Practice Database, we included 37 651 patients with hypertension from 231 general practices in Denmark. Recommended BP control was defined as BP <140/90 mm Hg in general and <130/80 mm Hg in patients with diabetes. The overall control rate was 33.2% (95% CI: 32.7 to 33.7). Only 16.5% (95% CI: 15.8 to 17.3) of patients with diabetes achieved BP control, whereas control rates ranged from 42.9% to 51.4% for patients with ischemic heart diseases or cerebrovascular or peripheral vascular diseases. A diagnosis of cardiac heart failure in addition to diabetes and/or CVD was associated with higher BP control rates, compared with men and women having only diabetes and/or CVD. A diagnosis of asthma in addition to diabetes and CVD was associated with higher BP control rates in men.
Conclusion
In Danish general practice, only 1 of 3 patients diagnosed with hypertension had a BP below target. BP control rates differ substantially within comorbidities. Other serious comorbidities in addition to diabetes and/or CVD were not associated with lower BP control rates; on the contrary, in some cases the BP control rates were higher when the patient was diagnosed with other serious comorbidities in addition to diabetes and/or CVD.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>23525411</pmid><doi>10.1161/JAHA.112.004531</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Open Access; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Adult Aged Antihypertensive Agents - therapeutic use Asthma - epidemiology Blood Pressure - drug effects cardiovascular diseases Cerebrovascular Disorders - epidemiology comorbidities Comorbidity Cross-Sectional Studies Denmark - epidemiology Diabetes Mellitus - epidemiology Female General Practice Heart Failure - epidemiology Humans hypertension Hypertension - diagnosis Hypertension - drug therapy Hypertension - epidemiology Hypertension - physiopathology Logistic Models Male Middle Aged Myocardial Ischemia - epidemiology Odds Ratio Original Research Peripheral Vascular Diseases - epidemiology primary care Primary Health Care Registries Risk Factors Treatment Outcome |
| title | Multimorbidity and Blood Pressure Control in 37 651 Hypertensive Patients From Danish General Practice |
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