Prevalence of patients using antihypertensive medication in Greenland, and an assessment of the importance of diagnosis for the associated quality of care – a cross-sectional study

Abstract

This study aimed to estimate the age- and sex specific prevalence of patients using antihypertensive medication in Greenland, and compared the quality of care between patients with and without a diagnosis for hypertension. The study was a cross-sectional study comparing patients using antihypertensive medication in 2020 (6,629 patients) and 2021 (7,008 patients), respectively. For data from 2021, patients with a medical diagnosis code were identified. Data was obtained from the Greenlandic electronic medical record. The population of Greenland was used as background population. Quality of care was evaluated based on suggested indicators by international guidelines and goals from Steno Diabetes Centre Greenland. The prevalence of patients aged ≥20 years using antihypertensive medication had increased from 16.7% in 2020 to 17.5% in 2021. The prevalence increased by age and was higher among women compared to men. In 2021, the prevalence of patients aged ≥20 years with a medical diagnosis code for hypertension was 7.9%. The use of antihypertensive medication in Greenland is common. The associated quality of care was low. However, process indicators were significantly improved when patients had a medical diagnosis code. Future focus must be on initiating initiatives ensuring that more patients are registered with a medical diagnosis code.

Trends in cardiovascular disease among Inuit in Greenland from 1994 to 2021

“…IHD and MI The decreasing trend in the IR of IHD found in this study and the higher risk among men vs women in Greenland is comparable to that in most European countries [ 24 ]. The declining IR, globally as in Greenland, can be explained by a raised focus on prevention, particularly declining rates of smoking, and improved treatment possibilities for clinical risk factors such as dyslipidemia, hypertension, and diabetes [ 22 , 23 , 33 ]. The IR of IHD progressively increased with age for both men and women, however, the difference between the oldest groups (70 and 80 years old) is remarkably small.…”

“…Conversely, the proportion of daily smokers has shown a decline from 68 % in 1993 to 52 % in 2018 [ 22 ]. By 2021, 17.5 % of those aged 20 and above were on antihypertensive medications [ 23 ]. Factors such as smoking, alcohol consumption, poor diet, and physical inactivity amplify CVD risks, with research suggesting that an optimal lifestyle could prevent nearly 80 % of IHD events [ [24] , [25] , [26] ].…”

Low prevalence of diagnosed asthma in Greenland – a call for increased focus on diagnosing

“…Adding medical diagnosis codes in the EMR and continuous monitoring of quality of care in Greenland has improved quality of care among patients who use antihypertensive medication [ 26 ].…”

Quality of care among patients diagnosed with atrial fibrillation in Greenland

“…Life expectancy in Greenland is estimated to be longer than that of other indigenous people [ 12 ], but significantly shorter than that in Western countries and approximately 10 years shorter than that in Denmark [ 13 , 14 ]. In addition, approximately half of the Greenlandic population are current smokers, and obesity is an increasing challenge in the Greenlandic healthcare system [ 13 , 15 , 16 ], as well as hypertension and diabetes [ 13 , 15 , 17 ].…”

“…Similarly, a lower quality of care has been observed in diseases which are not monitored as closely in Greenland, e.g. hypertension, chronic obstructive pulmonary disease (COPD), and asthma [ 17 , 20 , 21 ] and these studies have led to increased focus on registration of diagnosis codes and treatment. It is, therefore, essential to know the prevalence and the quality of AF to ensure quality of care.…”