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Predictors of hypertension detection in English general practices: a cross sectional study.

journal contribution
posted on 02.02.2021, 09:51 by Louis S Levene, Briana D Coles, Clare L Gillies, Sharmin Shabnam, Francesco Zaccardi, Kamlesh Khunti
Background Worldwide, high systolic blood pressure is the leading risk factor for deaths and disability-adjusted life-years but has been
historically under-detected. This study aimed to quantify differences between estimated and practice-detected prevalences of hypertension
across English general practices, and to determine how variations in detected prevalence could be explained by population-level and
service-level factors.
Methods Descriptive statistics, pair wise correlations between the independent variables and a multivariable regression analysis were
undertaken. In the regression model, the outcome was detected hypertension prevalence, adjusted for estimated prevalence, person-related
and disease-related determinants of illness and characteristics of general practices.
Results Detected prevalence was substantially lower than estimated prevalence (mean difference 16.23%; standard deviation 2.88%). Higher
detected prevalence was associated with increased deprivation, increased non-white ethnicity and urban location. Lower detected prevalence
was associated with larger list sizes, more general practitioners and being located in the South outside London. The final multivariable model’s
adjusted R2 value was 0.75.
Conclusions Substantial under-detection of hypertension is widespread across England. Independent of estimated prevalence, factors
associated with greater morbidity and population density predicted higher detected prevalence. Identifying patients with undetected
hypertension and coordinating care for these patients will require further resources and logistical support in community settings

History

Citation

Journal of Public Health, fdaa224, https://doi.org/10.1093/pubmed/fdaa224

Author affiliation

Diabetes Research Centre, College of Life Sciences

Version

AM (Accepted Manuscript)

Published in

J Public Health (Oxf)

Publisher

Oxford University Press (OUP)

issn

1741-3842

eissn

1741-3850

Acceptance date

09/11/2020

Copyright date

2021

Available date

13/01/2022

Spatial coverage

England

Language

eng

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