Hypertension control and treatment in Hong Kong: a cross sectional study

Abstract

INTRODUCTION Hypertension (HT) is the leading risk factor for global disease burden, and control of blood pressure (BP) is one of the most cost-effective methods to reduce premature cardiovascular morbidities and mortalities. This study aimed to review the control and treatment of HT patients in the public primary care setting in Hong Kong. METHOD Cross-sectional retrospective study on anonymous clinical data of HT patients without diabetes managed in public primary care clinics of the Hospital Authority in 1 July 2012 – 30 June 2013 was conducted. Descriptive statistics were used to analyze the clinical profile and management pattern of the primary care hypertension population. The last available BP reading of each case by the end of study period was used for analysis. RESULTS 205,745 HT patients were included in this study; mean age was 68.5 years and 57.6% were female. Overall, 73.6% HT patients achieved optimal BP control (<140/90mmHg), 23.1% had SBP/DBP 140-159/90-99mmHg and 3.3% had SBP/DBP ≥160/100mmHg. 13.1% patients suffered from at least one HT complications (coronary heart disease, stroke, heart failure or end-stage renal disease) and 27.4% among this group had blood pressure >140/90mmHg. Concerning HT management, 2.2% patients were managed by lifestyle intervention alone; approximately half of the patients required two or more anti-hypertensive medications. Calcium channel blocker was the most common anti-hypertensive drug used, and calcium channel blocker plus β-blocker was the most popular drug combination. DISCUSSION The standard of BP control among HT patients in HK public primary care is comparable with those achieved in developed countries such as the UK and USA. While this finding is reassuring, the significant proportion of patients with uncontrolled BP, especially those who had already developed complication(s), deserves our attention. A greater effort should be put into optimization of their management in order to attain the ultimate management goal – reduction of cardiovascular disease burden.