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Antihypertensive treatment and control according to gender, education, country of birth and psychiatric disorder: the Swedish Primary Care Cardiovascular Database (SPCCD)

Journal of Human Hypertension volume 29, pages 385–393 (2015)Cite this article

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Abstract

The reasons why women and men are treated with different antihypertensive drugs are not clear. Whether socioeconomic factors influence prescription patterns and blood pressure control differently in women and men has not been investigated. This cross-sectional study performed in a cohort of hypertensive patients from the Swedish Primary Care Cardiovascular Database (SPCCD) examined the influence of educational level, country of birth, gender and concomitant psychiatric disorder on prescription pattern and blood pressure control in 40 825 hypertensive patients. Men were more often than women treated with calcium channel blocker and angiotensin-converting enzyme inhibitor (ACEI), irrespective of education, country of birth and psychiatric disorder. Educational level influenced the prescription pattern to some extent, where the gender differences were reduced in patients with a higher educational level. In women, but not in men, high educational level and concomitant psychiatric disorder were associated with a higher proportion reaching target blood pressure. The predominant use of ACEI and calcium channel blockers in men is not influenced by educational level, country of birth or psychiatric disorder. Thus other explanations must be considered such as gender differences in side effects. Educational level seems to have a greater impact on reaching target blood pressure in women compared with men.

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Acknowledgements

Financial support was provided by the Swedish Heart Lung Foundation, Karolinska Institutet Research Foundations, the Health & Medical Care Committee of the Regional Executive Board of the Region Västra Götaland, the Swedish Society of Medicine (Lagerströms and Lysanders foundations), the Skaraborg Research and Development Council and the Stockholm County Council (Stockholm County Drug and Therapeutics Committee, the Department of Drug Management and Informatics and the EK-group of Centre for Family and Community Medicine). The SPCCD is endorsed by the Swedish Society for Hypertension, Stroke and Vascular Medicine. We acknowledge the important contribution of all participating primary health-care centers.

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Authors and Affiliations

  1. Department of Molecular and Clinical Medicine/Cardiology, Institute of Medicine, Sahlgrenska University Hospital, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden

    C Ljungman & K Manhem

  2. Department of Clinical Sciences, Division of Cardiovascular Medicine, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden

    T Kahan

  3. Institute of Medicine, Section of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden

    L Schiöler

  4. R & D Centre Skaraborg Primary Care, Skövde, Sweden

    P Hjerpe & K B Boström

  5. Department of Medicine, Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden

    B Wettermark

  6. Public Healthcare Services Committee, Stockholm County Council, Stockholm, Sweden

    B Wettermark

Authors
  1. C Ljungman
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  2. T Kahan
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Correspondence to C Ljungman.

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Ljungman, C., Kahan, T., Schiöler, L. et al. Antihypertensive treatment and control according to gender, education, country of birth and psychiatric disorder: the Swedish Primary Care Cardiovascular Database (SPCCD). J Hum Hypertens 29, 385–393 (2015). https://doi.org/10.1038/jhh.2014.100

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  • DOI: https://doi.org/10.1038/jhh.2014.100

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