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Trends and determinant factors in hypertension control in a population study with 25 years of follow-up

Andersen, Ulla O; Jensen, Gorm B

doi: 10.1097/HJH.0b013e328335fa81
Original papers: Therapeutic aspects

Objective: The present study focused on trend in hypertension control and on determinant factors that may influence efficacy in antihypertensive therapy. Two measures of treatment efficacy were used: population blood pressure and the relative frequency of effectively treated patients (blood pressure <140/90 mmHg).

Design and methods: Copenhagen City Heart Study is a prospective longitudinal epidemiological study with 25 years of follow-up. The study population were treated hypertensive patients. The blood pressure measurement was fully standardized and measurement method was unchanged throughout the observation period. A questionnaire was completed by the participants and double-checked by the technicians.

Results: The number of treated hypertensive patients increased considerably and hypertension control increased from 21 to 26%. Pretreatment SBP was stable in the observation period indicating that start-to-treat practice was stable. Treated SBP decreased from 157.9 to 148.7 mmHg. Four determinant factors were significant. Men presented a higher pretreatment SBP before starting antihypertensive medication. Elderly patients presented a higher pretreatment SBP and were poorly treated as compared with younger hypertensive patients. Obesity was associated with a high threshold SBP. The fourth factor was diagnosis. Patients with myocardial infarction were better treated in last surveys than patients from other diagnosis groups. Treated DBP was stable.

Conclusion: Hypertension treatment efficacy is improving but still far from acceptable. The evaluation of determinant factors identified four areas that need special attention: men, elderly and obese hypertensive patients. The fourth factor is diagnosis. The results may indicate a beneficial effect of systematic control of hypertensive patients during a limited time after a myocardial infarction.

Copenhagen City Heart Study, Epidemiological Research Unit, Copenhagen University Hospital, Bispebjerg, Denmark

Received 27 March, 2009

Revised 27 November, 2009

Accepted 1 December, 2009

Correspondence to Ulla O. Andersen, Sortedam Dossering 93B,, DK 2100 Copenhagen, Denmark Tel: +45 50 40 91 25; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.