Hypertension: a cross-sectional study of the role of multimorbidity in blood pressure control

BMC Family Practice

Research Article

Christopher Millett¹  Patrick White²  Mark Ashworth²  Chandra Sarkar²  Peter Schofield²  Hiten Dodhia³  James Crompton³ 

[1] Imperial College London, Faculty of Medicine, School of Public Health, South Kensington Campus, SW7 2AZ, London, UK;King’s College London, Department of Primary Care and Public Health Sciences, Capital House, 42 Weston Street, SE1 3QD, London, UK;Lambeth-Southwark Public Health Directorate, 160 Tooley Street, SE1 2QH, London, UK;

关键词: Systolic Blood Pressure;    Blood Pressure Control;    Blood Pressure Target;    Blood Pressure Reading;    Social Deprivation;   

DOI  :  10.1186/s12875-015-0313-y

 received in 2015-02-18, accepted in 2015-07-28,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundHypertension is the most prevalent cardiovascular long-term condition in the UK and is associated with a high rate of multimorbidity (MM). Multimorbidity increases with age, ethnicity and social deprivation. Previous studies have yielded conflicting findings about the relationship between MM and blood pressure (BP) control. Our aim was to investigate the relationship between multimorbidity and systolic blood pressure (SBP) in patients with hypertension.MethodsA cross-sectional analysis of anonymised primary care data was performed for a total of 299,180 adult patients of whom 31,676 (10.6 %) had a diagnosis of hypertension. We compared mean SBP in patients with hypertension alone and those with one or more co-morbidities and analysed the effect of type of comorbidity on SBP. We constructed a regression model to identify the determinants of SBP control.ResultsThe strongest predictor of mean SBP was the number of comorbidities, β −0.13 (p < 0.05). Other predictors included Afro-Caribbean ethnicity, β 0.05 (p < 0.05), South Asian ethnicity, β −0.03 (p < 0.05), age, β 0.05 (p < 0.05), male gender, β 0.05 (p < 0.05) and number of hypotensive drugs β 0.06 (p < 0.05). SBP was lower by a mean of 2.03 mmHg (−2.22, −1.85) for each additional comorbidity and was lower in MM regardless of the type of morbidity.ConclusionHypertensive patients with MM had lower SBP than those with hypertension alone; the greater the number of MM, the lower the SBP. We found no evidence that BP control was related to BP targets, medication category or specific co-morbidity. Further research is needed to determine whether consultation rate, “white-coat hypertension” or medication adherence influence BP control in MM.

【 授权许可】

CC BY   
© Sarkar et al. 2015