Various studies have suggested that a delay in the time between diagnosing hypertension and its correct control (D-C, diagnostic-control time) is linked to a worse prognosis. The aim of this study was to examine the relationship between D-C time and all-cause mortality, or the incidence of cardiovascular events, in patients more than 60 years newly diagnosed with hypertension.
This is a longitudinal, retrospective, population study employing data gathered from the electronic medical records of patients recently diagnosed with hypertension in 45 primary healthcare centres located in Barcelona (Catalonia). A multivariable logistic regression and Cox regression models were constructed. Goodness-of-fit was assessed through the Hosmer & Lemeshow test.
A total of 18 721 newly diagnosed hypertensive patients were included between 2007 and 2012. The follow-up lasted until October 2015, or the appearance of a cardiovascular event or death because of any cause. The median D-C time was 49 days and its distribution by tertiles was the following: 29 days or less, 30–124 days, and at least 125 days. Higher hypertensive status, obesity, diabetes mellitus, and male sex were independently associated with longer D-C time (≥125 days). At 5.4 years follow-up, patients with longer D-C times presented statistically significant greater incidence of all-cause mortality.
A delay in blood pressure control is significantly associated with an increase in the rate of all-cause mortality.
aLa Mina Primary Care Health Centre. University of Barcelona
bCardiovascular Research Group (GREC). Catalan Health Institute. Barcelona
cUnitat de Suport a la Recerca Barcelona. Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona
dEpidemiologia i Salut Pública, Universitat Internacional de Catalunya, Sant Cugat del Vallès
eUniversitat Autònoma de Barcelona, Barcelona, Spain
Correspondence to Ernest Vinyoles, CAP La Mina. Plaça M Àngels Rosell Simplicio, s/n. 08930 - Sant Adrià de Besòs. Barcelona, Spain. Tel: +34 933811593; fax: +34 933812141; e-mail: firstname.lastname@example.org
Abbreviations: CI, confidence interval; D-C, diagnostic-control; IR, incidence rate; JNC, Joint National Committee; OR, odds ratio
Received 9 March, 2018
Revised 18 June, 2018
Accepted 9 July, 2018