What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=99468). Intervention: Having ≥3 comorbidities vs. Fewer comorbidities. Primary outcome: Hypertension control (systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg) (OR 2.09, 95% CI 1.95-2.23).

February 1, 2021Open Access

Prevalence and determinants of hypertension control among almost 100 000 treated adults in the UK

Q: What are the key findings of this study?

Among treated hypertensive adults, only 38.1% achieved blood pressure control, with having ≥3 comorbidities being the strongest predictor of control (OR 2.09; 95% CI 1.95-2.23).

NTNeo TapelaBrigham and Women's Hospital JCJennifer A. CollisterUniversity of Oxford LCLei CliftonOpen Data Institute

Key Result

Among treated hypertensive adults, only 38.1% achieved blood pressure control, with having ≥3 comorbidities being the strongest predictor of control (OR 2.09; 95% CI 1.95-2.23).

Study Design

Type

Cross-Sectional (n=99,468)

Structured PICO

What are the prevalence and determinants of hypertension control among treated adults in the UK?

Population

99,468 previously diagnosed, treated middle-aged hypertensive adults enrolled in the UK Biobank.

Outcome

Hypertension control (defined as systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg)surrogate

The majority of treated hypertensive adults in the UK remain uncontrolled, highlighting a significant gap in cardiovascular risk management, particularly among older, obese, and minority populations.

Main Result

Odds Ratio: 2.09 (95% CI 1.95–2.23)

Abstract

OBJECTIVE: To identify factors associated with hypertension control among treated middle-aged UK adults. METHODS: A cross-sectional population-based study including 99 468 previously diagnosed, treated hypertensives enrolled in the UK Biobank. Hypertension control was defined as systolic blood pressure 30 units per week compared with none), black ethnicity (OR 0.73, 95% CI 0.65 to 0.82 compared with white), obesity (OR 0.73, 95% CI 0.71 to 0.76 compared with normal body mass index). The strongest positive association with control was having ≥3 comorbidities (OR 2.09, 95% CI 1.95 to 2.23). Comorbidities associated with control included cardiovascular disease (OR 2.11, 95% CI 2.04 to 2.19), migraines (OR 1.68, 95% CI 1.56 to 1.81), diabetes (OR 1.32, 95% CI 1.27 to 1.36) and depression (OR 1.27, 95% CI 1.20 to 1.34). CONCLUSIONS: In one of the largest population-based analyses of middle-aged adults with measured blood pressure, the majority of treated hypertensives were uncontrolled. Risk factors for hypertension were associated with a lower probability of control. Having a comorbidity was associated with higher probability of control, possibly due to more frequent interaction with the healthcare system and/or appropriate management of those at greater cardiovascular risk.

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