Inequities in hypertension: we can do better ... but how?

Hypertension is the most commonly reported long-term condition in the UK, estimated to affect one in three adults;1 however, it is underdiagnosed, and it is often suboptimally managed when diagnosed.2 This is despite well-established evidence that lifestyle modification and therapeutic treatment are highly effective in reducing fatal and non-fatal events, and morbidity. In this issue of the BJGP, two articles explore some of the obstacles to effective management of hypertension.3,4

Xu and colleagues explore the influence of continuity of care on cardiovascular disease (CVD) prevention for individuals with hypertension in Hong Kong.3 They consider a team-based continuity of care model by comparing the impact of being cared for by the same physician-team (typically comprising three physicians) versus multiple different teams. The study finds that patients with hypertension managed by the same physician-team are less likely to develop CVD or die than those cared for by a wider range of teams, with benefits of continuity greater in patients under the age of 65 and in those with fewer comorbidities. This study raises the question of whether continuity is an important element for effective blood pressure management.

Understanding exactly what is meant by continuity of care can be complicated: continuity of care is defined, assessed, and delivered in a variety of …

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