Visit patterns at primary care centres and individual blood pressure level – a cross-sectional study

Abstract Background: Serum uric acid (SUA) is strongly associated with hypertension and is associated with a variety of cardiovascular diseases. In this study we aimed to investigate the predictive effect of SUA and blood pressure on the left atrial (LA) size in Chinese south population. Methods: In this cross-sectional study, we investigated the association between SUA and LA diameter and studied the risk of LA enlargement among subjects with and without hyperuricemia (HU) in different grades of blood pressure in a single-center database (n=5392). Results: The LA diameter was significantly correlated with SUA(r=0.31, P<0.001). The incidence of LA enlargement was significantly greater in subjects with HU than in those without HU [25.7% vs. 14.2%, P<0.001; odds ratio (OR) = 2.09, 95% confidence interval (CI) = (1.78,2.45)], especially in women [21.8% vs. 7.4%, P<0.001; OR=3.50, 95%CI= (2.35, 5.22)]. In subjects with hypertension (≥140/90 mmHg) and HU, the risk of LA enlargement was 7.90 times higher than those with ideal blood pressure (< 120/80 mmHg) and normal SUA [33.1% vs. 5.9%; P<0.001, OR=7.90, 95% CI= (5.87,10.63)]. At the same blood pressure level, the risk of LA enlargement in HU subjects was higher than that in normal SUA (P<0.01). After adjustment for blood pressure, the effect of HU on LA size still exists[public OR=1.82, 95% CI=(1.54,2.14), P<0.001]. Conclusions: HU is an independent risk factor of LA enlargement in Chinese south population. SUA and blood pressure play a synergistic role in predicting the increase of LA diameter. Keywords: Uric acid, Hyperuricemia, Blood pressure, Left atrium

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Applicability to primary care of national clinical guidelines on blood pressure lowering for people with stroke: cross sectional study

BMJ ◽

10.1136/bmj.38758.600116.ae ◽

2006 ◽

Vol 332 (7542) ◽

pp. 635-637 ◽

Cited By ~ 26

Author(s):

Jonathan Mant ◽

Richard J McManus ◽

Rachel Hare

Keyword(s):

Blood Pressure ◽

Primary Care ◽

Clinical Guidelines ◽

Cross Sectional Study ◽

Sectional Study ◽

Blood Pressure Lowering ◽

Cross Sectional ◽

Pressure Lowering

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Pharmacotherapy of cardiovascular comorbidities in osteoporotic postmenopausal women

Osteoporosis and Bone Diseases ◽

10.14341/osteo2017117-21 ◽

2017 ◽

Vol 20 (1) ◽

pp. 17-21

Author(s):

Nadezhda V. Izmozherova ◽

Artem A. Popov

Keyword(s):

Blood Pressure ◽

Postmenopausal Women ◽

Enzyme Inhibitors ◽

Bone Fractures ◽

Blood Pressure Level ◽

Cross Sectional Study ◽

Sectional Study ◽

Treatment Needs ◽

Cross Sectional ◽

Cardiovascular Comorbidities

Aim: to assess tolerability and efficacy of cardiovascular comorbidities pharmacotherapy in osteoporotic postmenopausal women. Methods: cross-sectional study included 112 osteoporotic postmenopausal women aged from 49 to 85. Results: 95 persons (84.8%) had indications for angiotensine-convertising enzyme inhibitors (ACEI) prescription. Cough was associated with significantly higher odds of coronary heart disease, congestive heart failure and a trend to multiple bone fractures. Valsartan was initiated in 32 coughing patients. Target blood pressure level was reached in 15 women. In 15 cases blood pressure levels decreased by 30% of baseline level. Conclusion: efficacy of cardiovascular diseases in osteoporotic postmenopausal women treatment needs to be assessed in specially designed clinical trials.

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Prevalence of primary aldosteronism in primary care: a cross-sectional study

British Journal of General Practice ◽

10.3399/bjgp18x694589 ◽

2018 ◽

Vol 68 (667) ◽

pp. e114-e122 ◽

Cited By ~ 9

Author(s):

Sabine C Käyser ◽

Jaap Deinum ◽

Wim JC de Grauw ◽

Bianca WM Schalk ◽

Hans JHJ Bor ◽

...

Keyword(s):

Blood Pressure ◽

Primary Care ◽

Cross Sectional Study ◽

Plasma Aldosterone ◽

Infusion Test ◽

Newly Diagnosed ◽

Sectional Study ◽

Cross Sectional ◽

Plasma Aldosterone Concentration ◽

Aldosterone To Renin Ratio

BackgroundPrimary aldosteronism (PA) is the most frequent cause of secondary hypertension. Reported prevalences of PA vary considerably because of a large heterogeneity in study methodology.AimTo examine the proportion of patients with PA among patients with newly diagnosed, never treated hypertension.Design and settingA cross-sectional study set in primary care.MethodGPs measured aldosterone and renin in adult patients with newly diagnosed, never treated hypertension. Patients with elevated aldosterone-to-renin ratio and increased plasma aldosterone concentration underwent a saline infusion test to confirm or exclude PA. The source population was meticulously assessed to detect possible selection bias.ResultsOf 3748 patients with newly diagnosed hypertension, 343 patients were screened for PA. In nine out of 74 patients with an elevated aldosterone-to-renin ratio and increased plasma aldosterone concentration the diagnosis of PA was confirmed by a saline infusion test, resulting in a prevalence of 2.6% (95% confidence interval = 1.4 to 4.9). All patients with PA were normokalaemic and 8 out of 9 patients had sustained blood pressure >150/100 mmHg. Screened patients were younger (P<0.001) or showed higher blood pressure (P<0.001) than non-screened patients.ConclusionIn this study a prevalence of PA of 2.6% in a primary care setting was established, which is lower than estimates reported from other primary care studies so far. This study supports the screening strategy as recommended by the Endocrine Society Clinical Practice Guideline. The low proportion of screened patients (9.2%), of the large cohort of eligible patients, reflects the difficulty of conducting prevalence studies in primary care clinical practice.

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Fatores Associados a Tensão Arterial Não Controlada em Pessoas com Diabetes Tipo 2 Seguidas nos Cuidados de Saúde Primários em Portugal

Acta Médica Portuguesa ◽

10.20344/amp.8321 ◽

2017 ◽

Vol 30 (3) ◽

pp. 197 ◽

Cited By ~ 2

Author(s):

Inês Rosendo ◽

Luiz Miguel Santiago ◽

Margarida Marques

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Primary Care ◽

Regression Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Primary Care Patients

Introduction: Determine whether socio-demographic, habits and risk factors are associated with a better tensional control in type 2 diabetes in primary care patients in order to identify a specific target population for compensatory interventions improving diabetes control and reducing its morbi-mortality.Material and Methods: Cross-sectional study in primary care. Randomized type 2 diabetes patient data collection by their volunteer family doctors, proportionally stratified from the 5 Portuguese continental regions. Variables: blood pressure, age, gender, education, diabetes duration, HbA1c, smoking habits, weight, waist circumference, physical activity and adherence to medication. Bivariate and logistic regression analysis to evaluate each measured variable’s independent association with uncontrolled blood pressure (≥ 140/90).Results: 709 patients were included in the study, 60.2% men, mean age 66.12 ± 10.47 years. In logistic regression analysis, the factors independently associated to uncontrolled BP were lower education (p = 0.014), shorter diabetes duration (p = 0.002), higher waist circumference (p < 0.001), higher pulse pressure (p < 0.001), higher physical activity level (p = 0.043) and being a smoker (p < 0.001).Discussion: The main limitations are the fact that the sample was not totaly random and included only primary care patients, a possible inter-observer bias and being a cross-sectional study, thus not providing information on temporal relation or causality.Conclusion: The sub-group of people with diabetes identified to have worse tensional control should have a different and more intensive approach in primary care. We recommend further longitudinal and population based confirmatory research.

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