Continued Improvement in Hypertension Management in England

Falaschetti, Emanuela; Chaudhury, Moushumi; Mindell, Jennifer S.; Poulter, Neil

doi:10.1161/hypertensionaha.108.125617

Cited by 202 publications

(129 citation statements)

References 11 publications

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“…17 In particular, the lack of improvement in SBP may prevent the patients to receive the benefits of otherwise improved hypertension care. Compared with the prevalences of hypertension in our study, those reported since 2000 in other studies by age and sex have been lower in most, [18][19][20][21][22][23][24][25][26][27] but not in all populations. 27,28 As in our paper, the rate of awareness of hypertension in these reports was usually more than 60%.…”

Section: Discussioncontrasting

confidence: 91%

“…20,23 The hypertension care showed an improvement during 2003-2006 also in the Health Survey for England in 2006, particularly in women. 26 In the National Health and Nutrition Examination Survey during 1988-2004, hypertension prevalence increased significantly in all US older adults aged 60 years or over, 19 by race/ethnicity in both non-Hispanic white and black people. 27 In older men hypertension awareness, treatment and control increased significantly and the rates reached those seen in women.…”

Section: Discussionmentioning

confidence: 99%

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Despite evidence-based guidelines, systolic blood pressure remains inadequately controlled in older hypertensive adults

Antikaínen

Kastarinen

Jousilahti³

et al. 2009

J Hum Hypertens

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We aimed to assess the trends in the prevalence, awareness, treatment and control of hypertension in Finnish men and women aged 60-74 years. Three independent cross-sectional population surveys were conducted in 1997, 2002 and 2007 remained stable. The mean diastolic blood pressure (BP) decreased in both genders. Awareness of hypertension increased from 60 to 71% in men (Po0.001 for trend) and from 66 to 76% (P ¼ 0.012) in women. The prevalence of antihypertensive drug treatment among hypertensive people increased from 35 to 56% in both genders (Po0.001). The proportion of treated hypertensive patients with adequately controlled BP increased from 16 to 32% in men (Po0.001) and from 16 to 30% in women (P ¼ 0.003). Hypertension care in older adults has improved in Finland during 1997 to 2007. The situation is not optimal: the main problem in this age group is high SBP.

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Section: Discussioncontrasting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Despite evidence-based guidelines, systolic blood pressure remains inadequately controlled in older hypertensive adults

Antikaínen

Kastarinen

Jousilahti³

et al. 2009

J Hum Hypertens

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“…2 In the UK, despite some improvements in BP levels over recent years, nearly half those with hypertension do not have optimum control. 3,4 These results concur with international community-based studies showing BP goals are achieved in only 25-40% of patients on hypertensive drug treatment. 3,5 Self-monitoring of blood pressure (SMBP) by patients at home is one strategy whereby hypertensive patients can participate in managing their condition.…”

Section: Introductionsupporting

confidence: 67%

Improving management and effectiveness of home blood pressure monitoring: a qualitative UK primary care study

Grant

Greenfield

Nouwen³

et al. 2015

Br J Gen Pract

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BackgroundSelf-monitoring blood pressure (SMBP) is becoming an increasingly prevalent practice in UK primary care, yet there remains little conceptual understanding of why patients with hypertension engage in self-monitoring. AimTo identify psychological factors or processes prompting the decision to self-monitor blood pressure. Design and settingA qualitative study of patients previously participating in a survey study about SMBP from four general practices in the West Midlands. MethodTaped and transcribed in-depth interviews with 16 patients (6 currently monitoring, 2 used to self-monitor, and 8 had never self-monitored). Thematic analysis was undertaken. ResultsThree main themes emerged: 'self' and 'living with hypertension' described the emotional element of living with an asymptomatic condition; 'self-monitoring behaviour and medication' described overall views about self-monitoring, current practice, reasons for monitoring, and the impact on medication adherence; and 'the GP-patient transaction' described the power relations affecting decisions to self-monitor. Self-monitoring was performed by some as a protective tool against the fears of a silent but serious condition, whereas others self-monitor simply out of curiosity. People who self-monitored tended not to discuss this with their nurse or GP, partly due to perceiving minimal or no interest from their clinician about home monitoring, and partly due to fear of being prescribed additional medication. ConclusionThe decision to self-monitor appeared often to be an individual choice with no schedule or systems to integrate it with other medical care. Better recognition by clinicians that patients are self-monitoring, perhaps utilising the results in shared decision-making, might help integrate it into daily practice. Keywordshypertension; motivation; primary care; qualitative; self-monitoring.

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“…Hypertension is quite common in industrialized countries, [1][2][3] including Japan, 4 and is an important risk factor for cardiovascular disease (CVD), renal disease and eye disorders. [5][6][7] Large randomized controlled studies and a meta-analyses have established that antihypertensive medications reduce CVD morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Blood pressure re-screening for healthy adults: what is the best measure and interval?

et al. 2011

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Blood pressure (BP) screening is important to identify those at risk of cardiovascular disease, but there has been little data on the appropriate interval of screening. We aimed to evaluate the optimal interval and the best measure for BP re-screening by estimating the long-term, true change variance ('signal') and shortterm, within-person variance ('noise'). Study design was a cohort study from 2005 to 2008. Target population was Japanese healthy adults not taking antihypertensive medication at baseline, in a teaching hospital. We measured annually the systolic BP (SBP) and the diastolic BP (DBP), and calculated the pulse pressure (PP) and the mean arterial pressure (MAP). A total of 15 055 individuals (51% male) with a mean age of 49 years had annual check-ups. Short-term coefficient of variation was lowest for MAP at 5.2%, followed by SBP (5.7%) and DBP (5.8%), and highest for PP (12%). After 3 years, the 'signal' of true BP changes of only SBP and MAP equaled the 'noise' of BP measurement; however, it was larger for those with higher initial BPs. SBP or MAP appears to be a better screening measure. The optimal interval should be 3 years or more, with SBPo130 mm Hg and 2 years for those with SBPX130 mm Hg.

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Continued Improvement in Hypertension Management in England

Abstract: Abstract-This

Cited by 202 publications

References 11 publications

Despite evidence-based guidelines, systolic blood pressure remains inadequately controlled in older hypertensive adults

Despite evidence-based guidelines, systolic blood pressure remains inadequately controlled in older hypertensive adults

Improving management and effectiveness of home blood pressure monitoring: a qualitative UK primary care study

Blood pressure re-screening for healthy adults: what is the best measure and interval?

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