Skip to main content

Blood pressure monitoring and control by cardiovascular disease status in UK primary care

Cardiovascular diseases remain the main cause of morbidity and mortality in the UK. Strategies to reduce the burden of cardiovascular disease UK, such as the Quality & Outcomes Framework for general practitioners, have often emphasized improved management of high-risk individuals, rather than more population-based approaches to prevention. A recent study published in the Journal of Public Health Medicine by Anthony Laverty and colleagues from Imperial College London examined blood pressure monitoring and control among patients with and without cardiovascular disease in general practices in Wandsworth, London between 1998 and 2007. Logistic regression was used to assess associations among age, gender, ethnicity, deprivation and blood pressure control.

Laverty and colleagues found that the percentage of patients with elevated blood pressure (>140/90 mm Hg) decreased at a significantly slower rate in patients without cardiovascular disease (from 31.0 to 25.3%) compared with those with cardiovascular (from 56.8 to 36.0%). Mean systolic blood pressure decreased from 146.1 to 136.4 mm Hg in patients with cardiovascular disease and from 133.7 to 130.1 in patients without cardiovascular disease. Mean diastolic blood pressure decreased from 84.2 to 78.4 mm Hg in patients with cardiovascular disease; and from 80.5 to 79.0 in patients without cardiovascular disease. They also found that inequalities in blood pressure control decreased among age, ethnic and deprivation groups.

Laverty and colleagues concluded that measurement and control of blood pressure among those people with cardiovascular disease has improved much more rapidly compared with those without cardiovascular disease. This may have been a result of the guidance and incentives given to general practitioners to improve blood pressure control in people with cardiovascular disease.

Comments

Popular posts from this blog

Can GPs issue private prescriptions to NHS patients?

The NHS prescription charge in England is currently £8.60 per item. At this level, many commonly prescribed drugs will cost less than the prescription charge and so some NHS patients may occasionally ask if they can have a private prescription rather than an NHS prescription.

In the past, some GPs have been advised that they could issue both an NHS FP10 and a private prescription, and let the patient decide which to use. But the British Medical Association's General Practice Committee has obtained legal advice that said under the current primary care contract, GPs in England may not issue a private prescription alongside or as an alternative to an NHS FP10 prescription. In any consultation where a GP needs to issue an FP10, the concurrent issue of a private prescription would be a breach of NHS regulations.

The issuing of a private prescription in such circumstances could also be seen as an attempt to deprive the NHS of the funds it would receive from the prescription charge. Fur…

What will Brexit mean for the NHS?

On the 29 March 2017, the Prime Minister of the UK Theresa May, formally notified the European Union (EU) Council President, Donald Tusk, of the UK’s intention to leave the EU. Theresa May’s letter to Donald Tusk triggers a two-year process during which the UK will have to negotiate both the terms of its exit from EU and the arrangements that will replace those we have had for over 40 years with the other member states of the EU. The consequences of the United Kingdom’s departure from the EU (commonly referred to as ‘Brexit’) will be wide-ranging and will affect all areas of UK’s society, including the National Health Service (NHS).

For the NHS, Brexit comes at a time when it faces many other major challenges. These include severe financial pressures, rising workload, increased waiting times for both primary care and specialist services, and shortages of health professionals in many key areas (such as in general practice and in emergency departments). The NHS also faces challenges fr…

Dr Demis Hassabis, Co-Founder and CEO of DeepMind, Speaks about AI in Healthcare

On 28 September 2017, I attended the Annual Institute of Global Health Innovation Lecture: Artificial General Intelligence and Healthcare, delivered by Dr Demis Hassabis, co-founder and CEO of Google DeepMind. Artificial intelligence is the science of making machines smart argued Dr Hassabis, so how can we make it improve the healthcare sector? Dr Hassabis then went on to describe the work that DeepMind was carrying out in healthcare in areas such as organising information, deep learning to support the reporting of medical images (such as scans and pathology slides), and biomedical science. Dr Hassabis also discussed the challenges of applying techniques such as reinforcement learning in healthcare. He concluded that artificial intelligence has great scope for improving healthcare; for example, by prioritising the tasks that clinicians had to carry out and by providing decision support aids for both patients and doctors. Dr Hassabis also discussed some of the ethical issues in using …