OBJECTIVE: To identify factors associated with hypertension control among treated middle-aged UK adults.
METHODS: A cross-sectional population-based study including 99 468 previously diagnosed, treated hypertensives enrolled in the UK Biobank . Hypertension control was defined as systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg .
RESULTS: Median age was 62.3 years (IQR 57.3 to 66.0), 45.9% female , 92.0% white , 40.1% obese , 9.3% current smokers and 19.4% had prior cardiovascular disease . 38.1% (95% CI 37.8% to 38.4 %) were controlled . In multivariable logistic regression, associations with lack of hypertension control included: older age (OR 0.61 , 95% CI 0.58 to 0.64 for 60-69 years compared with age 40-50 years), higher alcohol use (OR 0.61 , 95% CI 0.58 to 0.64, for consuming> 30 units per week compared with none), black ethnicity (OR 0.73 , 95% CI 0.65 to 0.82 compared with white), obesity (OR 0.73 , 95% CI 0.71 to 0.76 compared with normal body mass index). The strongest positive association with control was having ≥3 comorbidities (OR 2.09 , 95% CI 1.95 to 2.23). Comorbidities associated with control included cardiovascular disease (OR 2.11 , 95% CI 2.04 to 2.19), migraines (OR 1.68 , 95% CI 1.56 to 1.81), diabetes (OR 1.32 , 95% CI 1.27 to 1.36) and depression (OR 1.27 , 95% CI 1.20 to 1.34).
CONCLUSIONS: In one of the largest population-based analyses of middle-aged adults with measured blood pressure, the majority of treated hypertensives were uncontrolled . Risk factors for hypertension were associated with a lower probability of control . Having a comorbidity was associated with higher probability of control, possibly due to more frequent interaction with the healthcare system and/or appropriate management of those at greater cardiovascular risk.
Index: epidemiology, health care, hypertension, outcome assessment