FREQUENCY OF MEDICAL OUT-PATIENT VISITS AND USE OF HOME BLOOD PRESSURE MONITORING IN HYPERTENSIVE PATIENTS IN FIVE EUROPEAN COUNTRIES

Objective: We assessed the frequency of out-patient visits for hypertension and the use of home blood pressure monitoring (HBPM) in 5 European countries.Design and method: We used the data of a web-based questionnaire developed by the Working group on Lifestyle, Cardiovascular Therapy and Adherence to investigate patients’ perspectives on hypertension management. Eligible participants were adult men and women, living in France, Germany, Italy, Spain and UK, with a confirmed diagnosis of hypertension. Data were collected through patients’ organizations and internet from January to March 2022.Results: From January to March 2022, we included 2757 participants, 46% women, 94% older than 60 y, 71% with hypertension duration >5y, 95% (91% for >3 months) treated with a mean of 1.7 antihypertensive pills /day (all medications: 4.1 pills/day). The out-patient visit frequency was monthly in 3% of the participants, once every 1 to 3 months in 23%, once every 3 to 6 months in 28%, once every 6 to 12 months in 30%, and less than once a year in 13%. There was large between-country variability in visit frequency (e.g., once every 1 to 3 months: 5% in UK, 21% in Germany, and 42% France; once every 6 to 12 months: 47% in UK, 23% in Germany, and 13% in France). Overall, 67% of participants performed HBPM themselves and 13% with an external help. HBPM was done on a regular basis in most patients (17% every day, 26% several times a week, 35% several times a month) while 8% did HBPM only when not feeling well. HBPM was performed more frequently in Germany and less in UK. Patients at higher cardiovascular risk did HBPM more frequently.Conclusions: There are no strong evidence-based recommendations on the frequency of out-patient visits for hypertension during long-term follow-up. Our survey shows a large variability between European countries in the way patients are followed. Moreover, strong implementation of HBPM is found in all countries, but the ESH protocol is not strictly followed. Therefore, studies are needed to define the most cost-effective hypertension follow-up and ESH recommendations for HBPM should be reinforced.</p

Baseline characteristics of patients after matching according to type of heart failure.

<p>*/**Statistical significance of differences between groups tested by the ML chi-square test for categorical variables and by the independent Student’s <i>t</i>-test for continuous variables</p><p>*/**p<0.05/p<0.001</p><p>^aParameters used in a logistic regression model of a propensity score</p><p>^bMedication at discharge was computed on patients who were alive after discharge</p><p>LVEF—left ventricular ejection fraction, BP—blood pressure, MI—myocardial infarction, TIA—transient ischemic attack, PCI—percutaneous coronary intervention, CABG—coronary artery bypass graft, PM—pacemaker, ICD—implantable cardioverter–defibrillator, CRT—cardiac resynchronization therapy, COPD—chronic obstructive pulmonary disease, ARB—angiotensin-2 receptor blockers.</p><p>Baseline characteristics of patients after matching according to type of heart failure.</p

Baseline characteristics of patients before and after matching.

<p>*/**Statistical significance of differences between groups was tested by the ML chi-square test for categorical variables and by the independent Student’s <i>t</i>-test for continuous variables</p><p>*/**p<0.05/p<0.001</p><p>^aParameter used in a logistic regression model of a propensity score</p><p>^bParameter was not known for all patients, and statistics were computed on a reduced basis</p><p>^cMedication at discharge was computed on patients who were alive after discharge</p><p>LVEF—left ventricular ejection fraction, BP—blood pressure, MI—myocardial infarction, TIA—transient ischemic attack, PCI—percutaneous coronary intervention, CABG—coronary artery bypass graft, PM—pacemaker, ICD—implantable cardioverter–defibrillator, CRT—cardiac resynchronization therapy, COPD—chronic obstructive pulmonary disease, ARB—angiotensin-2 receptor blockers.</p><p>Baseline characteristics of patients before and after matching.</p

Thirty-day mortality according to the BMI category and type of heart failure.

<p>Thirty-day mortality according to the BMI category and type of heart failure.</p

Long-term mortality for all patients according to a BMI of 25 kg/m² in a non-balanced and balanced dataset and for ADHF and <i>de novo</i> AHF patients.

<p>Long-term mortality for all patients according to a BMI of 25 kg/m² in a non-balanced and balanced dataset and for ADHF and <i>de novo</i> AHF patients.</p

Definition of datasets.

<p>Definition of datasets.</p