Treatment patterns of hypertension and dyslipidaemia in hypertensive patients at higher and lower risk of cardiovascular disease in primary care in the United Kingdom

Abstract

Few studies have investigated the presence of dyslipidaemia in hypertensive individuals. In addition, few data exist on the concurrent treatment of both conditions for the prevention of cardiovascular disease (CVD). This retrospective cohort study examined treatment patterns for hypertension and dyslipidaemia among hypertensive patients in UK primary care. We defined a population of patients aged X40 years from the UK General Practice Research Database. Hypertensive individuals with X3 additional cardiovascular risk factors (ARFs) were compared with a cohort comprising hypertensive patients with p2 ARFs. We analysed the prevalence of risk factors and the prevalence and incidence of treatment for hypertension, dyslipidaemia and for both conditions between January 1997 and December 2001. A total of 117 840 hypertensive patients were identified (23 655 with X3 ARFs, 94 185 with p2 ARFs) in 1997; in 2001, the number diagnosed as hypertensive was 133 683 (40 248 X3 ARFs, 93 435 p2 ARFs). The prevalence of antihypertensive treatment in the hypertensive patients with X3 ARFs increased during the study. In 2001, approximately one-third of hypertensive patients with X3 ARFs were not receiving antihypertensives. Among those patients who received such treatment, the majority received X2 separate agents in accordance with current guidelines. Treatment for concurrent hypertension and dyslipidaemia was initiated in o8% of patients with hypertension and X3 ARFs in each year. These findings demonstrate the under-recognition/undertreatment of cardiovascular risk factors in UK primary care among patients at risk of CVD.

Are doctors assessing patients with hypertension appropriately at their initial presentation?

“…This is similar to the findings of a study conducted in the United Kingdom (13) that suggested the presence of a gap in the clinical care for hypertension; in particular, missed opportunities to detect and prevent CVD and TOD. This gap could have a negative impact on the morbidity and mortality of such patients.…”

Underdiagnosis and undertreatment of cardiovascular risk factors in patients with moderate to severe psoriasis

“…Undertreatment of CV comorbidities is a commonly encountered problem in clinical practice and has also been observed in nonpsoriasis populations, including patients with diabetes, 43 high-risk dyslipidemic patients with or without established CV disease, 44,45 and high-risk hypertensive patients. 46 Similar findings have also been reported for patients with lupus and RA. In one study, only 23% of patients with lupus had lipid panels determined and only 21% of those with hypercholesterolemia were receiving treatment.…”

Undertreatment of dyslipidemia: from the Arabian Gulf to the USA. Time to solve this problem!

“…These two conditions, among others, increase CVD risk and there is an absolute necessity to effectively treat all CVD risk factors, among which is dyslipidemia. Similar data are reported by the CEPHEUS South Africa Study 6 , the CEPHEUS Pan-Asia Study 7 , the CEPHEUS Centralized Pan-European Study 8 and other European Countries 9 as well as the OLYMPIC and the metabolic syndrome Greece (n ¼ 10,000) studies 10,11 , a study from the UK (n ¼ 117,840) 12 and a study from the US National Health and Nutrition Examination Survey 13 . The recent Euroaspire IV 14 included high risk individuals (coronary patients) from 26 countries 14 .…”