Improved treatment and control of hypertension in Swedish primary care: results from the Swedish primary care cardiovascular database

Objective:To study temporal trends in hypertension treatment and control in Swedish primary care, in relation to clinical characteristics, comorbidity, and drug treatment.Materials and methods:Repeated cross-sectional analysis of 43239 hypertensive patients attending primary care in 2001-2002 and of 62407 patients in 2007-2008.Results:Mean blood pressure (BP) 2007-2008 was 143/79mmHg in women and 142/81mmHg in men. Cardiovascular comorbidity and diabetes were present in 13 and 15% of women, and in 18 and 20% of men. Overall BP reductions from 2001-2002 to 2007-2008 were 9.0/3.1mmHg; greater in women than men, with advancing age, and in patients with comorbidity (all P<0.001). Attainment of target BP (<140/90mmHg) increased from 24 and 26% in women and men (2001-2002) to 37 and 37% (2007-2008; all P<0.001). Most common drug classes in 2001-2002 were, in descending frequency, blockers, diuretics, and calcium channel blockers (both sexes), and in 2007-2008 blockers, diuretics, and angiotensin-converting enzyme inhibitors in women, and blockers, angiotensin-converting enzyme inhibitors, and diuretics in men. The number of drug classes/patient increased from 1.5 (2001-2002) to 1.8 (2007-2008; P<0.001) but remained low (1.7) in those above target BP.Conclusion:BP control in hypertensive patients attending Swedish primary care has improved over 5-7 years, and more so in high-risk groups. There is, however, room for improvement. In uncontrolled hypertension the combination of several drug classes remain low.