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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.

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