Abstract:
BACKGROUND:Patients requiring anticoagulation suffer from comorbidities such as hypertension. On the occasion of INR monitoring, general practitioners (GPs) have the opportunity to control for blood pressure (BP). We aimed to evaluate the impact of Vitamin-K Antagonist (VKA) monitoring by GPs on BP control in patients with hypertension. METHODS:We cross-sectionally analyzed the database of the Swiss Family Medicine ICPC Research using Electronic Medical Records (FIRE) of 60 general practices in a primary care setting in Switzerland. This database includes 113,335 patients who visited their GP between 2009 and 2013. We identified patients with hypertension based on antihypertensive medication prescribed for ≥ 6 months. We compared patients with VKA for ≥ 3 months and patients without such treatment regarding BP control. We adjusted for age, sex, observation period, number of consultations and comorbidity. RESULTS:We identified 4,412 patients with hypertension and blood pressure recordings in the FIRE database. Among these, 569 (12.9%) were on Phenprocoumon (VKA) and 3,843 (87.1%) had no anticoagulation. Mean systolic and diastolic BP was significantly lower in the VKA group (130.6 ± 14.9 vs 139.8 ± 15.8 and 76.6 ± 7.9 vs 81.3 ± 9.3 mm Hg) (p < 0.001 for both). The difference remained after adjusting for possible confounders. Systolic and diastolic BP were significantly lower in the VKA group, reaching a mean difference of -8.4 mm Hg (95% CI -9.8 to -7.0 mm Hg) and -1.5 mm Hg (95% CI -2.3 to -0.7 mm Hg), respectively (p < 0.001 for both). CONCLUSIONS:In a large sample of hypertensive patients in Switzerland, VKA treatment was independently associated with better systolic and diastolic BP control. The observed effect could be due to better compliance with antihypertensive medication in patients treated with VKA. Therefore, we conclude to be aware of this possible benefit especially in patients with lower expected compliance and with multimorbidity.
journal_name
BMC Cardiovasc Disordjournal_title
BMC cardiovascular disordersauthors
Streit S,Kaplan V,Busato A,Djalali S,Senn O,Meli DN,FIRE Study Group.doi
10.1186/s12872-015-0053-xsubject
Has Abstractpub_date
2015-06-10 00:00:00pages
47issn
1471-2261pii
10.1186/s12872-015-0053-xjournal_volume
15pub_type
杂志文章abstract:BACKGROUND:Infective endocarditis is an uncommon but life-threatening infectious disease. To our knowledge, current investigations of the characteristics of infective endocarditis in our region are scarce. In this study, we aimed to investigate the changes in the epidemiology and clinical features of infective endocard...
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pub_type: 杂志文章
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pub_type: 临床试验,杂志文章,多中心研究
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pub_type: 评论,杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章,meta分析
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