Abstracts / Posters
Hypertension in UK primary care: Obese versus normal weight patients
Accepted for oral presentation at Heart UK Conference, July 2004
The Counterweight Project Team
Aims: To document the impact of obesity on the prevalence and management of hypertension in the UK primary care setting.
Methods: The Counterweight Programme is a national multi- centre initiative aimed at auditing and improving obesity management in primary care. 1150 obese patients (Body Mass Index BMI >30 kg/m2) and 1150 age and sex-matched normal weight controls (BMI 18.5<25 kg/m2) were randomly selected from primary care registers and data collected on screening, incidence, monitoring and drug treatments of hypertension. Data were collected on all anti-hypertensive drugs issued over an 18 month period to assess the impact of obesity on prescribing burden.
Results: Blood pressure monitoring occurred more frequently in diabetic patients compared with non-diabetics (p<0.001) and in obese compared to normal weight (p<0.001). Increasing degree of obesity had no impact on blood pressure monitoring (p=0.328). Prevalence of diagnosed hypertension was significantly affected by the presence of obesity increasing degree of obesity. 80% of hypertensives received drug treatment independent of BMI. Choice of anti-hypertensive drug was affected by obesity, calcium channel blockers more often prescribed for normal weight and ACE inhibitors for the obese (p= 0.022). Prescribing burden, measured using defined daily doses, is increased between 2.5-4 fold for all anti-hypertensive drugs in the obese.
Conclusions: Hypertension is well documented in primary care registers but this audit suggests sub optimal drug management, independent of BMI. Between 2.5 and 4 times more anti-hypertensive drugs are currently prescribed to the obese.