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Blood pressure monitoring and control by cardiovascular disease status in UK primary care: 10 year retrospective cohort study 1998-2007.

BACKGROUND
Strategies to reduce the burden of cardiovascular disease (CVD) in the UK have emphasized improved management of high-risk individuals rather than population-based approaches.


METHODS
This 10-year retrospective cohort study examined blood pressure (BP) monitoring and control among patients with and without CVD in general practices in Wandsworth, London between 1998 and 2007. Logistic regression was used to assess associations among age, gender, ethnicity, deprivation and BP control.


RESULTS
The percentage of patients with elevated BP (>140/90 mm Hg) decreased at a slower rate in patients without CVD (31.0-25.3%) compared with those with CVD (56.8-36.0%) (P < 0.001). Mean systolic BP decreased from 146.1 to 136.4 mm Hg in patients with CVD and from 133.7 to 130.1 in patients without CVD. Mean diastolic BP decreased from 84.2 to 78.4 mm Hg in patients with CVD and from 80.5 to 79.0 in patients without CVD. Inequalities in BP control decreased among age, ethnic and deprivation groups but increased between men and women without CVD.


CONCLUSIONS
Measurement and control of BP among those with CVD has improved much more rapidly compared with those without CVD. Inequalities in BP control appeared to increase between men and women without CVD, but decreased among age, ethnicity and deprivation groups.