Stroke Clinical Trial
Official title:
Predictors of Blood Pressure Control and Associations With Cardiovascular Diseases in Individuals With High Blood Pressure: a CALIBER Study
Current guidelines for the clinical management of hypertension in adults recommend to
achieve and maintain blood pressure levels of <140/90 mmHg. However, it is uncertain what
proportion of individuals identified with high blood pressure in primary care actually reach
blood pressure control, what factors are associated with attainment of control and to what
extent blood pressure control attainment is associated with cardiovascular diseases in a
contemporary population of individuals diagnosed with high blood pressure.
The aim of this study is to investigate the extent to which patients achieve blood pressure
control and associated risk factors, time to attainment of blood pressure control and
whether this time is associated with an increased risk of CVD onset, all-cause and
cardiovascular disease and end-stage renal disease.
An increment of 20 mmHg of systolic blood pressure (or approximately equivalent 10 mmHg
diastolic blood pressure) is associated with more than a two-fold increase in risk of fatal
stroke, and with a two-fold increase in fatal ischemic heart diseases in individuals aged
40-69 years. The management and control of high blood pressure is therefore one of the most
important components of primary and secondary strategies for prevention of cardiovascular
mortality and morbidity. Current guidelines for the clinical management of hypertension in
adults recommend to achieve and maintain blood pressure levels of <140/90 mmHg. However, it
is uncertain what proportion of individuals identified with high blood pressure in primary
care actually reach blood pressure control, what factors are associated with attainment of
control and to what extent blood pressure control attainment is associated with
cardiovascular diseases in a contemporary population of individuals diagnosed with high
blood pressure. This is important for clinicians and policy decision makers in order to
design and implement effective strategies for patient management.
The aim of this study is to investigate the extent to which patients achieve blood pressure
control and associated risk factors, time to attainment of blood pressure control and
whether this time is associated with an increased risk of CVD onset, all-cause and
cardiovascular disease and end-stage renal disease.
The study will use data from the CALIBER data set of clinically collected electronic health
record data from England.
This study is part of the CALIBER (Cardiovascular disease research using linked bespoke
studies and electronic records) programme funded over 5 years from the National Institute
for Health Research (NIHR) and Wellcome Trust. The central theme of the CALIBER research is
linkage of the Myocardial Ischaemia National Audit Project (MINAP) with primary care
(Clinical Practice Research Datalink - CPRD) and other resources. The overarching aim of
CALIBER is to better understand the aetiology and prognosis of specific coronary phenotypes
across a range of causal domains, particularly where electronic records provide a
contribution beyond traditional studies. CALIBER has received both Ethics approval (ref
09/H0810/16) and ECC approval (ref ECC 2-06(b)/2009 CALIBER data set).
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Observational Model: Cohort, Time Perspective: Prospective
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