scholarly journals Blood pressure and cholesterol measurements in primary care: cross-sectional analyses in a dynamic cohort

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0131
Author(s):  
Annemarijn de Boer ◽  
Monika Hollander ◽  
Ineke van Dis ◽  
Frank L.J. Visseren ◽  
Michiel L Bots ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Mixed Model ◽  
Time Window ◽  
Guideline Implementation ◽  
Cross Sectional ◽  
Menopausal Women ◽  
History Of ◽  
Post Menopausal

BackgroundGuidelines on cardiovascular risk management (CVRM) recommend blood pressure (BP) and cholesterol measurements every five years in men ≥40 and (post-menopausal) women ≥50 years.AimEvaluate CVRM guideline implementation.Design & settingCross-sectional analyses in a dynamic cohort using primary care electronic health record (EHR) data from the Julius General Practitioners’ Network (n=388,929).MethodWe assessed trends (2008–2018) in the proportion of patients with at least one measurement (BP and cholesterol) every one, two, and five years, in those with a history of (1) cardiovascular disease (CVD) and diabetes, (2) diabetes only, (3) CVD only, (4) cardiovascular risk assessment (CRA) indication based on other medical history, or (5) no CRA indication. We evaluated trends over time using logistic regression mixed model analyses.ResultsTrends in annual BP and cholesterol measurement increased for patients with a history of CVD from 37.0% to 48.4% (P<0.001) and 25.8% to 40.2% (P<0.001). In the five-year window 2014–2018, BP and cholesterol measurements were performed in respectively 78.5% and 74.1% of all men ≥40 years and 82.2% and 78.5% in all women ≥50 years. Least measured were patients without a CRA indication: men 60.2% and 62.4%; women 55.5% and 59.3%.ConclusionThe fairly high frequency of CVRM measurements available in the EHR of patients in primary care suggests an adequate implementation of the CVRM guideline. As nearly all individuals visit the general practitioner once within a five-year time window, improvement of CVRM remains very well possible, especially in those without a CRA indication.

scholarly journals Trends in prevalence of prehypertension and hypertension, awareness, treatment, control and cardiovascular risk factors in relatively large sample of Iranian menopausal women: 2001-2016

2019 ◽  
Author(s):  
Maryam Eghbali-Babadi ◽  
Alireza Khosravi ◽  
Awat Feizi ◽  
Hassan Alikhasi ◽  
Narges Kheirollahi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Clinical Information ◽  
Cluster Sampling ◽  
Treatment Control ◽  
Cross Sectional ◽  
Menopausal Women ◽  
Hypertension Awareness

Abstract Background prehypertension and hypertension are risk factors for cardiovascular disease. Despite its importance, hypertension is often underestimated and undiagnosed, especially in women. This study was designed to determine trends in prevalence of prehypertension and hypertension, awareness, treatment, control and cardiovascular risk factors among the Iranian menopausal women. Methods This repeated Cross-sectional study was conducted on 8073 individuals which 1013 of these subjects were menopausal women older than 40, in Iran, in the years of 2001, 2007 and 2016. Samples were selected through random, multistage, cluster sampling. The data collected by the questionnaire included clinical information and blood pressure was determined via arm digital blood pressure monitors. Results The prevalence of hypertension was in the years 2001, 2007 and 2016, respectively % 52.6, % 49.0 and % 51.6, no significant changes were observed(p=0.628). The prevalence of Prehypertension over these years (% 56.6, %.53.3 and % 42.2) was significantly decreased (p=0.006). The Trends of awareness (p=0.015), treatment (p=0.009) and control (p<0.001) of hypertension in menopausal women with high blood pressure has significantly increased. Despite the increasing trends of drug treatment for hypertension, hypertension is uncontrolled in more than a third of subjects. Hyperlipidemia, diabetes mellitus and Body mass index increased significantly from 2001 to 2016 among the menopausal women. Conclusions The results showed that hypertension and Prehypertension are highly prevalent among Iranian menopausal women and markedly increased with age. Interventional population-based approaches are needed to improve knowledge and efficient practice that may help lower the risk for hypertension and CVD among this at risk population.

scholarly journals Lateral back pain identifies prevalent vertebral fractures in post-menopausal women: cross-sectional analysis of a primary care-based cohort

Rheumatology ◽  
2009 ◽  
Vol 49 (3) ◽  
pp. 505-512 ◽  
Author(s):  
E. M. Clark ◽  
A. P. Hutchinson ◽  
E. V. McCloskey ◽  
M. D. Stone ◽  
J. C. Martin ◽  
...  
Keyword(s):  
Primary Care ◽  
Back Pain ◽  
Vertebral Fractures ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Sectional Analysis

scholarly journals Trends in the Degree of Control and Treatment of Cardiovascular Risk Factors in People With Type 2 Diabetes in a Primary Care Setting in Catalonia During 2007–2018

2022 ◽  
Vol 12 ◽  
Author(s):  
Manel Mata-Cases ◽  
Bogdan Vlacho ◽  
Jordi Real ◽  
Ramon Puig-Treserra ◽  
Magdalena Bundó ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Beta Blockers ◽  
Density Lipoprotein ◽  
Cross Sectional ◽  
Lipid Control

ObjectiveTo assess the trends in cardiovascular risk factor control and drug therapy from 2007 to 2018 in subjects with type 2 diabetes mellitus (T2DM).Materials and MethodsCross-sectional analysis using yearly clinical data and treatment obtained from the SIDIAP database. Patients aged ≥18 years with a diagnosis of T2DM seen in primary care in Catalonia, Spain. ResultsThe number of T2DM patients increased from 299,855 in 2007 to 394,266 in 2018. We also found an increasing prevalence of cardiovascular disease, heart failure, and chronic kidney disease (from 18.4 to 24.4%, from 4.5 to 7.3%, and from 20.2 to 31.3%, respectively). The achievement of glycemic targets (HbA1c&lt;7%) scarcely changed (54.9% to 55.9%). Major improvements were seen in blood pressure (≤140/90 mmHg: from 55% to 71.8%), and in lipid control (low-density lipoprotein cholesterol &lt;100 mg/dl: 33.4% to 48.4%), especially in people with established cardiovascular disease (48.8 to 69.7%). Simultaneous achievement of all three targets improved from 12.5% to 20.1% in the overall population and from 24.5% to 32.2% in those with cardiovascular disease but plateaued after 2013. There was an increase in the percentage of patients treated with any antidiabetic drug (70.1% to 81.0%), especially metformin (47.7% to 67.7%), and DPP4i (0 to 22.6%). The use of SGLT-2 and GLP-1ra increased over the years, but remained very low in 2018 (5.5% and 2.1% of subjects, respectively). There were also relevant increases in the use of statins (38.0% to 49.2%), renin-angiotensin system (RAS) drugs (52.5% to 57.2%), and beta-blockers (14.3% to 22.7%).ConclusionsDuring the 2007-2018 period, relevant improvements in blood pressure and lipid control occurred, especially in people with cardiovascular disease. Despite the increase in the use of antidiabetic and cardiovascular drugs, the proportion of patients in which the three objectives were simultaneously achieved is still insufficient and plateaued after 2013. The use of antidiabetic drugs with demonstrated cardio renal benefits (SGLT-2 and GLP-1ra) increased over the years, but their use remained quite low.

scholarly journals Perception and self-management of hypertension in Chinese cardiologists (CCHS): a multicenter, large-scale cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029249 ◽  
Author(s):  
Lei Hou ◽  
Xuejuan Jin ◽  
Jianying Ma ◽  
Juying Qian ◽  
Yong Huo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Antihypertensive Drugs ◽  
Secondary Outcome ◽  
Hospital Level ◽  
Cross Sectional ◽  
Academic Degree ◽  
History Of ◽  
Professional Title

ObjectivesTo determine the frequency of risk factors for hypertension among Chinese cardiologists using a nation-wide survey.DesignMulticenter, cross-sectional observational study.Setting2441 hospitals across China were surveyed between September 2016 and August 2017.ParticipantsAll in-service cardiologists were surveyed (n=28 924).InterventionsWeChat-based electronic data capture system, a social application in China (Tencent, Nanshan, China), was used for data acquisition. Physician subscribed to the WeChat official account of the China Cardiologist Heart Study, and filled out an online questionnaire that included age, gender, level of in-service hospital, professional title, academic degree, area of expertise and cardiovascular risk factors. All information was required.Primary and secondary outcome measuresThe primary outcome was the presence of cardiovascular risk factors. The secondary outcome was the impact of the risk factors on the occurrence of hypertension.ResultsAmong 28 924 Chinese cardiologists who completed the questionnaire, 57.6% had blood pressure of 130–139/80–89 mm Hg (5.3% were taking antihypertensive drugs) and 22.0% had blood pressure>140/>90 mm Hg (36.5% were taking antihypertensive drugs). The multivariable analysis showed that age, gender, academic degree, hospital level, body mass index (BMI), smoking and comorbidities were independently associated with hypertension among cardiologists (all p<0.05). Age, female gender, BMI, smoking, family history of cardiovascular diseases (CVDs) and comorbidities were independently associated with taking antihypertensive drugs among hypertensive cardiologists (all p<0.05). Age, hospital level, professional title, BMI, family history of CVDs and comorbidities were independently associated with reaching target blood pressure among hypertensive cardiologists taking antihypertensive drugs.ConclusionChinese cardiologists do not recognise and pay attention to their own blood pressure. Their rate of antihypertensive treatment was low. The identified risk factors could be used to identify cardiologists at higher risk for hypertension and for implementing preventive interventions.

scholarly journals Sex differences in cardiovascular risk management for people with diabetes in primary care: a cross-sectional study

BJGP Open ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. bjgpopen19X101645 ◽  
Author(s):  
Marit de Jong ◽  
Rimke C Vos ◽  
Rianneke de Ritter ◽  
Carla J van der Kallen ◽  
Simone J Sep ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Risk Management ◽  
Sex Differences ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Cross Sectional ◽  
Cardiovascular Risk Management

BackgroundDiabetes is a stronger risk factor for cardiovascular complications in women than men.AimTo evaluate whether there are sex differences in cardiovascular risk management in patients with diabetes in primary care.Design & settingA cross-sectional study was undertaken using data from 12 512 individuals with diabetes within the Dutch Julius General Practitioners Network (JGPN) from 2013.MethodLinear and Poisson regression analyses were used to assess sex differences in risk factor levels, assessment, treatment, and control.ResultsNo sex differences were found in HbA1c levels and control, while small differences were found for cardiovascular risk management. Blood pressure levels were higher (mean difference [MD] 1.09 mmHg; 95% confidence intervals [CI] = 0.41 to 1.77), while cholesterol levels (MD -0.38 mmol/l; 95% CI = -0.42 to -0.34) and body mass index ([BMI] MD -1.79 kg/m2; 95% CI = -2.03 to 1.56) were lower in men than women. Risk factor assessment was similar between sexes, apart from high-density lipoprotein cholesterol (HDL-c), which was more commonly assessed in women (risk ratio [RR] 1.16; 95% CI = 1.13 to 1.20). Among those with a treatment indication for prevention, women with cardiovascular disease (CVD) were less likely to receive lipid-lowering drugs (RR 0.84; 95% CI = 0.76 to 0.93) than men, while women without CVD were more likely to receive lipid-lowering drugs (RR 1.16; 95% CI = 1.04 to 1.2). Among those treated, women were more likely to achieve systolic blood pressure (SBP) control (RR 1.06; 95% CI = 1.02 to 1.10) and less likely to achieve low-density lipoprotein cholesterol (LDL-c) control (RR 0.88; 95% CI = 0.85 to 0.91) than men.ConclusionIn this Dutch primary care setting, sex differences in risk factor assessment and treatment of people with diabetes were small. However, women with diabetes were less likely to achieve control for LDL-c and more likely to achieve blood pressure control than men with diabetes.

scholarly journals Diet quality in relation to the risk of hypertension among Iranian adults: cross-sectional analysis of Fasa PERSIAN cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Amir Motamedi ◽  
Maryam Ekramzadeh ◽  
Ehsan Bahramali ◽  
Mojtaba Farjam ◽  
Reza Homayounfar
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Diet Quality ◽  
Dietary Diversity ◽  
Antihypertensive Drugs ◽  
Healthy Eating Index ◽  
Cross Sectional ◽  
Common Chronic Disease ◽  
History Of ◽  
Prevention Of Hypertension

Abstract Background Hypertension is a common chronic disease with various complications and is a main contributing factor to cardiovascular disease (CVD). This study aimed to assess the association of diet quality, assessed by dietary diversity score (DDS), Mediterranean dietary score (MDS), diet quality index-international (DQI-I), and healthy eating index-2015 (HEI-2015) with the risk of hypertension. Methods This study recruited a total of 10,111 individuals (45.14% male) with mean age of 48.63 ± 9.57 years from the Fasa Cohort Study, Iran. Indices of diet quality, including MDS, HEI-2015, DQI-I, and DDS were computed by a 125-item Food Frequency Questionnaire. Participants were diagnosed as hypertensive if they had a diastolic blood pressure (DBP) ≥90 mmHg, systolic blood pressure (SBP) ≥140 mmHg,, or used antihypertensive drugs. Results Hypertension was prevalent in 28.3% of the population (21.59% in males and 33.74% in females). In the whole population, after adjustment for potential covariates, including daily energy intake, age, gender, physical activity, smoking, family history of hypertension, body mass index, and the level of education, higher adherence to the MDS (OR: 0.86, 95%CI = 0.75–0.99) and HEI-2015 (OR: 0.79, 95%CI = 0.68–0.90) was significantly associated with decreased risk of hypertension. The protective effect of HEI-2015 against hypertension remained significant for both males (OR: 0.80, 95%CI = 0.64–0.99) and females (OR: 0.78, 95%CI = 0.66–0.94), while, for MDS, this relationship disappeared in the subgroup analysis by gender. DQI-I and DDS were not related to the odds of hypertension. Conclusions Adhering to MDS and HEI-2015 diets could contribute to the prevention of hypertension.

scholarly journals The CUORE project cardiovascular risk assessment in primary care: the ongoing experience in Italy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Palmieri ◽  
S Vannucchi ◽  
C Lo Noce ◽  
A Di Lonardo ◽  
B Unim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Assessment ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Adult Population ◽  
Cardiovascular Risk Assessment ◽  
Project Risk ◽  
Preventive Actions

Abstract Background Italian National Prevention Plan 2005-08 included 10-year cardiovascular risk assessment (10-CR) for the general population aged 35-69 years using the CUORE Project risk score. GPs were encouraged to perform 10-CR and send data to the Cardiovascular Risk Observatory (CRO). Aim To show updated data of the ongoing surveillance system of the 10-CR in the Italian adult population. Methods Data were collected using the cuore.exe software, freely downloadable by GPs from the CUORE Project website (www.cuore.iss.it). The CRO provides a web-platform to compare data on 10-CR and risk factors at regional/national level. For persons examined at least twice, variations in risk factors from baseline to follow-up and 95% confidence intervals (C.I.) were calculated using methods for matched pair samples. Results Up to February 2019, about 3,500 GPs downloaded cuore.exe; about 300,000 CR assessments on about 140,000 persons were sent to CRO. Mean CR was 3.1% in women (W), 8.5% in men (M); 28% of M, 64% of W were at low risk (CR &lt; 3%); 9.9% of M, 0.4% of W were at high risk (CR ≥ 20%); 26% of M, 16% of W were current smokers; 13% of M, 10% of W were diabetic; 33% of hypertensive M, 35% of hypertensive W were under specific treatment. Among those with at least two risk assessments (31% of the sample), 11% shifted to a lower risk class after one year (14% of M, 7% of W). Systolic blood pressure mean levels decreased by 0.6 mmHg (95%-C.I. 0.3-0.8 mmHg), diastolic blood pressure by 0.5 mmHg (0.2-0.7 mmHg), total cholesterol by 4.1 mg/dl (3.0-5.2 mg/dl), smokers prevalence by 3.1% (2.3%-4.0%); HDL-cholesterol increased in W by 0.3 mg/dl (0.1-0.5 mg/dl). Conclusions Data demonstrate that 10-CR assessment can be an effective first step to implement preventive actions in primary care. Individual risk score is a useful tool for GPs to assess CR and promote primary prevention focusing on the adoption of healthy lifestyles. Data can be used to support health policy decision process. Key messages The cuore.exe software, freely downloadable from the CUORE Project website-www.cuore.iss.it, allows GPs to assess the CUORE Project risk score, to collect and to send data to the CVD Risk Observatory. 10 year Cardiovascular Risk assessment in the general adult population can be an effective first step to implement preventive actions in primary care.

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