Lipid lowering in primary prevention: time to focus on young patients

Hayek, Ahmad; Marquis‐Gravel, Guillaume

doi:10.1136/heartjnl-2022-321972

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…[22] Similar concerns have been expressed about statin under-treatment. [24] Lastly, this study highlights the importance of indicator choice in understanding control of hypertension. The difference between BLOOD_PRESSURE_CONTROLLED and the QOF derived HYPERTENSION_CONTROLLED indicators has been previously noted as reflecting missing recordings rather than reduction in control.…”

Section: Discussionmentioning

confidence: 80%

Inequities in hypertension management: an observational cross-sectional study in North-East London using electronic health records

Rison

Redfern

Dostal

et al. 2023

Preprint

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Background: Hypertension is a key potentially modifiable risk factor for cardiovascular disease- the leading cause of death in the UK. Good blood pressure (BP) control reduces mortality; however, health inequalities may lead to variability in hypertension management. Aim: To investigate health inequities related to ethnicity, sex, age, and socio-economic status in the treatment and control of BP in a large cohort of adult patients with hypertension. Design and Setting: A cross-sectional cohort study of adults with hypertension registered with general practices in North East London on 1st April 2019. Method: Multivariable logistic regression was used to estimate associations of demographics and treatment intensity on the following hypertension management indicators: 1) BP recording in last 12 months, 2) BP on age-adjusted target, 3) BP on age-adjusted target and BP recorded in last 12 months. Results: In total, 156,296 adults were included. Black/Black British ethnic groups were less likely to have controlled BP than White ethnic groups (OR 0.89, 95% CI = 0.86-0.92). Asian/Asian British ethnic groups were more likely to have controlled blood pressure (OR 1.29, 95% CI = 1.25-1.34). Ethnic differences in control could not be explained by the likelihood of having a recent blood pressure recording, nor by treatment intensity differences. Older adults were more likely to have controlled hypertension than younger patients. Conclusion: Black/Black British and younger people are less likely to have controlled hypertension and may warrant targeted interventions. Possible explanations for these findings are presented and further research is needed on reasons for ethnic differences.

show abstract

Section: Discussionmentioning

confidence: 80%

Inequities in hypertension management: an observational cross-sectional study in North-East London using electronic health records

Rison

Redfern

Dostal

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…[25] Similar concerns have been expressed about statin under-treatment in younger patients. [27] Lastly, this study highlights the importance of indicator choice in assessing cohort-level management of hypertension. The difference between BLOOD_PRESSURE_CONTROLLED and the QOF derived HYPERTENSION_CONTROLLED indicators has been previously noted as reflecting missing recordings rather than reduction in control.…”

Section: Discussionmentioning

confidence: 84%

Inequities in hypertension management: observational cross-sectional study in North East London using electronic health records

Rison

Redfern²,

Dostal

et al. 2023

Br J Gen Pract

View full text Add to dashboard Cite

Background: Hypertension is a key modifiable risk factor for cardiovascular disease –the leading cause of death in the UK. Good blood pressure (BP) control reduces mortality. However, health inequities may lead to variability in hypertension monitoring and control. Aim: To investigate health inequities related to ethnicity, sex, age, and socio-economic status in the monitoring, treatment and control of BP in a large cohort of adult patients with hypertension. Design and Setting: A cross-sectional cohort study of adults with hypertension registered with general practices in North East London on 1st April 2019. Method: Multivariable logistic regression was used to estimate associations of demographics and treatment intensity on the following hypertension management indicators: 1)BP recording in last 12 months, 2)BP on age-adjusted target, 3)BP on age-adjusted target and BP recorded in last 12 months. Results: In total, 156,296 adults were included. The Black ethnicity group was less likely to have controlled BP than the White ethnicity group (OR 0.89, 95% CI = 0.86-0.92). The Asian ethnicity group was more likely to have controlled blood pressure (OR 1.29, 95% CI = 1.25-1.34). Ethnicity differences in control could not be explained by the likelihood of having a recent blood pressure recording, nor by treatment intensity differences. Older adults were more likely to have controlled hypertension than younger patients. Conclusion: Black ethnicity individuals and younger people are less likely to have controlled hypertension and may warrant targeted interventions. Possible explanations for these findings are presented but further research is needed on reasons for ethnic differences.

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“…In the accompanying editorial, Hayek and Marquis-Gravel8 point out that ‘Because this study only includes patients who experienced a CV event, who still represent a minority of individuals <55 years old in the population, it does not inform us on a more global populational health perspective. Indeed, the risk of STEMI in young patients cannot be extrapolated from a series like this one because the denominator is unknown.’ Even so, ‘as clinicians, it is our duty to continue carefully screening and initiating primary prevention strategies even in our younger patients at high risk for cardiovascular diseases.’…”

mentioning

confidence: 99%

Heartbeat: clinical practice patterns for valve intervention in adults with aortic stenosis

Otto

2023

Heart

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Lipid lowering in primary prevention: time to focus on young patients

Cited by 3 publications

References 9 publications

Inequities in hypertension management: an observational cross-sectional study in North-East London using electronic health records

Inequities in hypertension management: an observational cross-sectional study in North-East London using electronic health records

Inequities in hypertension management: observational cross-sectional study in North East London using electronic health records

Heartbeat: clinical practice patterns for valve intervention in adults with aortic stenosis

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