Having 6 or more healthcare visits was the strongest driver of hypertension screening compared to a single visit (RR 2.79; 95% CI 2.77-2.81).
Cohort (n=514,729)
No
What factors determine whether hypertension screening occurs in primary care among individuals without known hypertension?
Hypertension screening in primary care is primarily driven by the frequency of healthcare visits rather than patient risk factors, highlighting the need for better opportunistic screening strategies.
Relative Risk: 2.79 (95% CI 2.77–2.81)
Objective: It is well-known that about half of individuals with hypertension are not detected. However, it is unknown which factors determine whether screening occurs. We aimed to estimate factors associated with the probability of screening among a listed population that visited a primary healthcare centre over nine years within one County. Design and method: We analysed electronic health records data for 514,729 listed individuals without hypertension between 2015 and 2023 who had visited a primary healthcare centre. We defined risk group as having overweight, obesity, registered unhealthy living habits, age 50 years or older, or previous type 2 diabetes, cardiovascular- or chronic kidney disease. We used generalised estimating equations with a Poisson distribution and log link function, together with an unstructured working correlation matrix and a robust variance, to estimate factors associated with the probability of screening. Results: Overall, 34% were screened during the study period. The number of healthcare visits had the most dominant effect on the probability of screening, with a clear dose–response pattern (RR 1.61; 95% CI 1.60–1.62 for two visits and RR 2.79; 95% CI 2.77–2.81 for 6 visits or more compared with one visit). Followed by belonging to a risk group (RR=1.46; 95% CI 1.45-1.47), older age (RR 1.05; 95% CI 1.04–1.05 for 50–69 years; RR 1.34; 95% CI 1.33–1.35 for 70 years or older compared with 18–49 years), born outside Europe (RR 1.23; 95% CI 1.22–1.24), and female sex (RR 1.08; 95% CI 1.07–1.08). Individuals in the three lowest income Quintiles had a slightly higher likelihood of screening than those in the highest, and educational level showed a small effect in the fully adjusted model. Greater continuity of care was associated with a moderate increase in screening probability (RR 1.10; 95% CI 1.09–1.12). Conclusions: Hypertension screening is driven mainly by how often people visit healthcare. Screening is prioritised for risk group, but men are still screened less than women, which might be due to higher health awareness among women. Enhanced resources and support systems are needed for increased opportunistic screening in primary healthcare among those at risk, especially men.
Guðjónsdóttir et al. (Fri,) conducted a cohort in Hypertension screening (n=514,729). 6 or more healthcare visits vs. 1 healthcare visit was evaluated on Probability of hypertension screening (RR 2.79, 95% CI 2.77-2.81). Having 6 or more healthcare visits was the strongest driver of hypertension screening compared to a single visit (RR 2.79; 95% CI 2.77-2.81).