Control of high blood pressure in just 2 out of 5 patients in the UK with the condition, despite treatment, suggests a large population-based study, published in the online journal Open Heart.
Older people (60+), of black ethnicity, and on relatively low incomes (£ 18,000 / year) are less likely to be under well-controlled blood pressure, the findings show tell.
High blood pressure is the leading potential risk factor for cardiovascular disease death, affecting more than 1.3 billion people worldwide and responsible for about half of all strokes and strokes. heart attacks.
Lowering blood pressure can cut the number of strokes by 35% -40%, heart attacks by 20% -25%, and heart failure by 50%. But despite the fact that cheap drug treatments are readily available, many people remain undiagnosed or inadequately treated, the researchers point out.
So they wanted to find out how well blood pressure is managed among people aged 40-69 who have been diagnosed with the condition and are taking medication to treat it in the UK as well. on identifying any relevant factors related to better or worse control.
The researchers drew baseline survey data from the UK Biobank (UKB), a large study based on a population of half a million people aged 40-69 living within 40 km of 22 assessment centers across England, Scotland and Wales between 2006 and 2010.
They identified potentially influential factors: social and demographic characteristics; risk factors for cardiovascular disease – alcohol intake, smoking, physical activity levels, weight (BMI) – and blood pressure control – number and type of concomitant cardiometabolic, respiratory, psychosocial and neurological conditions, the number of drugs taken to treat the condition, and a surrogate for health care use – previous bowel cancer screening.
Among all 459,484 Biobank participants, more than half (56%; 256,203) had high blood pressure. Blood pressure readings above 140/90 mm Hg are considered high.
Nearly half of people with high blood pressure (47%, 120,211) were unaware of their condition; 27% (36,524) of those who were aware were not taking drugs for its treatment.
Some 99,468 people were included in the final study: their average age was 62; 46% (45,607) were women. The majority (93%; 92,385) were white and about a quarter (25,606) had just been educated to primary school level.
Approximately 1 in 5 (19%; 19,344) were diagnosed with cardiovascular disease; 4 in 10 (40%; 39,887) were obese; and about 1 in 10 (9%; 9254) were regular smokers.
On average, they were diagnosed with high blood pressure 7 years earlier. Just under 14% had 3 or more drugs to treat the condition.
Among the 19,344 with cardiovascular disease, approximately 1 in 5 (19%; 3740) had 3 or more high blood pressure drugs; as 9886 (12.5%) of the 79,022 had no non-smoker or obese cardiovascular disease.
Only 2 out of 5 middle-aged people treated had high blood pressure under control. Blood pressure was controlled in only about 38% of those receiving treatment, meaning that nearly two-thirds (61,543; 62%) did not receive proper treatment.
When a blood pressure threshold above 160/100 mm Hg was applied, it was found that 20,573 (21%) were not receiving proper treatment for the condition. In fact, nearly 4% (3754) of those receiving systolic blood pressure treatment had at least 180 mm Hg or diastolic blood pressure at least 110 mm Hg.
The homozygous conditions were strongly associated with blood pressure control, including those unrelated to an increased risk of cardiovascular disease.
Factors associated with poor blood pressure control included older age (60+), male sex, drinking 30 or more units of alcohol per week, black ethnicity and obesity.
Low family income (£ 18,000 a year), low educational attainment, and manual labor were also associated with poor blood pressure control.
But smoking was associated with higher odds (24%) of blood pressure control, possibly as a result of more intensive treatment to cut smokers ’higher risk of cardiovascular disease, the researchers said.
And a diagnosis of 3 or more conditions was associated with doubling the numbers of blood pressure controls.
These most common homozygous conditions associated with blood pressure control were known as cardiovascular disease (double the number), irregular heart rhythm (72% higher odds), migraines (68% higher odds), anxiety (47% higher odds), diabetes (32% higher odds) and depression (27% higher odds).
Despite the fact that this is one of the largest population-based studies to look at the control of high blood pressure in middle-aged adults, there are some gates, however, warn the researchers.
These include reliance on related self-report and drug treatment conditions, and the fact that UK Biobank baseline data do not include information on influencing factors such as adherence drug treatment and use of health care services.
“Comorbidity was associated with a higher likelihood of control, possibly as a result of more frequent interactions with the health care system and / or appropriate management of those at greater cardiovascular risk,” note near the researchers.
“More research is needed to understand barriers [high blood pressure] control, and the tactics that underpin the connection between [it] and comorbidities unrelated to elevation [cardiovascular disease] danger, “they conclude.
###
External peer review? there is
Type of evidence: Observation
Subjects: People