Multimorbidity and blood pressure control in patients attending primary care in Canada

Nguyen, T. N. et al. (2023) Multimorbidity and blood pressure control in patients attending primary care in Canada. Journal of Primary Care and Community Health, 14, pp. 1-9. (doi: 10.1177/21501319231215025) (PMID:38097504) (PMCID:PMC10725138)

Abstract

Background: There has been conflicting evidence on the association between multimorbidity and blood pressure (BP) control. This study aimed to investigate this associations in people with hypertension attending primary care in Canada, and to assess whether individual long-term conditions are associated with BP control. Methods: This was a cross-sectional study in people with hypertension attending primary care in Toronto between January 1, 2017 and December 31, 2019. Uncontrolled BP was defined as systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg. A list of 11 a priori selected chronic conditions was used to define multimorbidity. Multimorbidity was defined as having ≥1 long-term condition in addition to hypertension. Logistic regression models were used to estimate the association between multimorbidity (or individual long-term conditions) with uncontrolled BP. Results: A total of 67 385 patients with hypertension were included. They had a mean age of 70, 53.1% were female, 80.6% had multimorbidity, and 35.7% had uncontrolled BP. Patients with multimorbidity had lower odds of uncontrolled BP than those without multimorbidity (adjusted OR = 0.72, 95% CI 0.68-0.76). Among the long-term conditions, diabetes (aOR = 0.73, 95%CI 0.70-0.77), heart failure (aOR = 0.81, 95%CI 0.73-0.91), ischemic heart disease (aOR = 0.74, 95%CI 0.69-0.79), schizophrenia (aOR = 0.79, 95%CI 0.65-0.97), depression/anxiety (aOR = 0.91, 95%CI 0.86-0.95), dementia (aOR = 0.87, 95%CI 0.80-0.95), and osteoarthritis (aOR = 0.89, 95%CI 0.85-0.93) were associated with a lower likelihood of uncontrolled BP. Conclusion: We found that multimorbidity was associated with better BP control. Several conditions were associated with better control, including diabetes, heart failure, ischemic heart disease, schizophrenia, depression/anxiety, dementia, and osteoarthritis.

• Item Type: Articles
• Keywords: Primary care, hypertension, high blood pressure, multimorbidity, blood pressure control.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Jani, Dr Bhautesh and Hanlon, Dr Peter and Mair, Professor Frances and Nicholl, Dr Barbara
• Authors: Nguyen, T. N., Kalia, S., Hanlon, P., Jani, B. D., Nicholl, B. I., Christie, C. D., Aliarzadeh, B., Moineddin, R., Harrison, C., Chow, C., Fortin, M., Mair, F. S., and Greiver, M.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Journal of Primary Care and Community Health
• Publisher: SAGE Publications
• ISSN: 2150-1319
• ISSN (Online): 2150-1327
• Published Online: 14 December 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Journal of Primary Care and Community Health 14:1-9
• Publisher Policy: Reproduced under a Creative Commons licence