Evidence map›Paper›PMID 39107017›Full record

Observational studyBMJ open2024

COVID-19 pandemic impact on hypertension management in North East London: an observational cohort study using electronic health records.

Stuart Christopher Gorthorn Rison, Oliver C Redfern, Rohini Mathur, Isabel Dostal, Chris Carvalho, Zahra Raisi-Estabragh, John Robson

Abstract readObservational Study
In one paragraph

Observational study in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Stuart Christopher Gorthorn RisonClinical Effectiveness Group, Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK s.rison@qmul.ac.uk.ORCID 0000-0003-3289-6668
Oliver C RedfernNuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK.ORCID 0000-0002-3596-3806
Rohini MathurClinical Effectiveness Group, Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.ORCID 0000-0002-3817-8790
Isabel DostalClinical Effectiveness Group, Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.ORCID 0009-0007-8896-3010
Chris CarvalhoClinical Effectiveness Group, Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.ORCID 0000-0002-4114-9210
Zahra Raisi-EstabraghSaint Bartholomew's Hospital Barts Heart Centre, London, UK.ORCID 0000-0002-7757-5465
John RobsonClinical Effectiveness Group, Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.ORCID 0000-0001-6889-0415

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThere are established inequities in the monitoring and management of hypertension in England. The COVID-19 pandemic had a major impact on primary care management of long-term conditions such as hypertension. This study investigated the possible disproportionate impact of the pandemic across patient groups.

designOpen cohort of people with diagnosed hypertension. SETTINGS: North East London primary care practices from January 2019 to October 2022.

participantsAll 224 329 adults with hypertension registered in 193 primary care practices. OUTCOMES: Monitoring and management of hypertension were assessed using two indicators: (i) blood pressure recorded within 1 year of the index date and (ii) blood pressure control to national clinical practice guidelines.

resultsThe proportion of patients with a contemporaneous blood pressure recording fell from a 91% pre-pandemic peak to 62% at the end of the pandemic lockdown and improved to 77% by the end of the study. This was paralleled by the proportion of individuals with controlled hypertension which fell from a 73% pre-pandemic peak to 50% at the end of the pandemic lockdown and improved to 60% by the end of the study. However, when excluding patients without a recent blood pressure recording, the proportions of patients with controlled hypertension increased to 81%, 80% and 78% respectively.Throughout the study, in comparison to the White ethnic group, the Black ethnic group was less likely to achieve adequate blood pressure control (ORs 0.81 (95% CI 0.78 to 0.85, p<0.001) to 0.87 (95% CI 0.84 to 0.91, p<0.001)). Conversely, the Asian ethnic group was more likely to have controlled blood pressure (ORs 1.09 (95% CI 1.05 to 1.14, p<0.001) to 1.28 (95% CI 1.23 to 1.32, p<0.001)). Men, younger individuals, more affluent individuals, individuals with unknown or unrecorded ethnicity or those untreated were also less likely to have blood pressure control to target throughout the study.

conclusionThe COVID-19 pandemic had a greater impact on blood pressure recording than on blood pressure control. Inequities in blood pressure control persisted during the pandemic and remain outstanding.

Indexed as

COVID-19Electronic Health RecordsHypertensionSARS-CoV-2AdultAgedAntihypertensive AgentsBlood PressureBlood Pressure DeterminationCohort StudiesFemaleHumansLondonMaleMiddle AgedPandemicsAntihypertensive AgentsBlood PressureCardiovascular DiseaseHealth EquityHypertensionPrimary CarePUBLIC HEALTH

Identifiers

PMID39107017
PMCPMC11308888

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.