Antihypertensive therapy prescribing was lower among hypertensive patients at high calculated CVD risk (57.4%) compared to those at low risk (63.3%), indicating suboptimal guideline adherence.
Cross-Sectional (n=571,492)
Yes
In Australian primary care, absolute CVD risk calculation is only possible in half of hypertensive patients, and antihypertensive prescribing is not adequately guided by absolute CVD risk, highlighting suboptimal guideline adherence.
Absolute Event Rate: 57.4% vs 63.3%
Hypertension guidelines recommend that absolute cardiovascular disease (CVD) risk guide the management of hypertensive patients. This study aimed to assess the proportion of patients with diagnosed hypertension with sufficient data to calculate absolute CVD risk and determine whether CVD risk is associated with prescribing of antihypertensive therapies. This was a cross-sectional study using a large national database of electronic medical records of patients attending general practice in 2018 (MedicineInsight). Of 571,492 patients aged 45-74 years without a history of CVD, 251,733 40.6% (95% CI: 39.8-41.2) had a recorded hypertension diagnosis. The proportion of patients with sufficient recorded data available to calculate CVD risk was higher for patients diagnosed with hypertension 51.0% (95% CI: 48.0-53.9) than for patients without a diagnosis of hypertension 38.7% (95% CI: 36.5-41.0). Of those patients with sufficient data to calculate CVD risk, 29.3% (95% CI: 28.1-30.6) were at high risk clinically, 6.0% (95% CI: 5.8-6.3) were at high risk based on their CVD risk score, 12.8% (95% CI: 12.5-13.2) at moderate risk and 51.8% (95% CI: 50.8-52.9) at low risk. The overall prevalence of antihypertensive therapy was 60.9% (95% CI: 59.3-62.5). Prescribing was slightly lower in patients at high risk based on their CVD risk score 57.4% (95% CI: 55.4-59.4) compared with those at low 63.3% (95% CI: 61.9-64.8) or moderate risk 61.8% (95% CI: 60.2-63.4) or at high risk clinically 64.1% (95% CI: 61.9-66.3). Guideline adherence is suboptimal, and many patients miss out on treatments that may prevent future CVD events.
Roseleur et al. (Mon,) conducted a cross-sectional in Hypertension (n=571,492). Antihypertensive therapy vs. Low CVD risk was evaluated on Prescribing of antihypertensive therapy. Antihypertensive therapy prescribing was lower among hypertensive patients at high calculated CVD risk (57.4%) compared to those at low risk (63.3%), indicating suboptimal guideline adherence.