Factors associated with blood pressure control in Swedish primary care patients with hypertension: a cross-sectional study

This study aimed to investigate the factors associated with blood pressure control in a primary healthcare population with hypertension. We used baseline data from a recent Swedish randomized controlled trial where 400 patients diagnosed with hypertension from 10 primary health care centers were included. The participants underwent blood pressure measurements, blood sampling and completed questionnaires on quality of life, physical activities, tobacco- and alcohol use, medication, and comorbidities. Logistic regression analyses were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with blood pressure control (<140/90 mmHg). The mean age of the participants was 69 years. The results showed blood pressure control in 41% of the cases. The factors that had the highest ORs for achieving blood pressure control were previous myocardial infarction (OR 2.44; CI 1.08–5.53), diabetes diagnosis (OR 2.26; CI 1.31–3.88), and use of ≥2 blood pressure medications (OR 1.62; CI 1.07–2.46). Family history of hypertension was negatively associated with blood pressure control (OR 0.29; CI 0.38–0.88) (univariate analyses). Our study found an association between the use of ≥2 antihypertensive medications and blood pressure control. Despite current treatment guidelines for hypertension, the use of single-drug therapy remains common. By shifting from single drug to combination therapy, focusing on patients with a family history of hypertension and those without comorbidities, the proportion achieving blood pressure control could increase significantly. ClinicalTrials.gov (NCT04407962).