Evaluation of time delay between discovery of a high blood pressure in a health screening survey and hypertension diagnosis.

Purpose: Early treatment of hypertension is important to reduce adverse cardiovascular outcomes. The aim of this study was to investigate the time delay from detection of a high blood pressure in a health screening survey to hypertension diagnosis in primary care.

Materials and methods: Seventy years old inhabitants in the Uppsala County were randomly invited to the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. We found 409 individuals without antihypertensive treatment with a blood pressure >140/90 mmHg, being the average of three recordings measured after 30 min rest in a supine position. These individuals were recommended to ask their primary care physician to further investigate this finding.

Results: During 10 years of follow-up, 285 of them (70%) received a hypertension diagnosis. The mean time to diagnosis was 5 (SD 2) years. The chance of receiving a diagnosis of hypertension during the follow-up period in this group with elevated blood pressure at baseline was related to the systolic blood pressure (OR 1.04 per 1 mmHg, 95%CI 1.02-1.04), the BMI (OR 1.06 per 1 kg/m², 95%CI 1.01-1.12), and statin use (OR 3.76, 95%CI 1.35-10.3) at the health survey, but was not significantly related to sex, prevalence of diabetes, or use of salicylic acid. No significant interaction between sex and systolic blood pressure regarding hypertension diagnosis was observed.

Conclusion: In conclusion, when an elevated blood pressure was discovered in elderly persons at a health screening, 70% of those received a hypertension diagnosis within 10 years, with a mean time to diagnosis of 5 years. Health care actions should be enforced to shorten this time lag both in terms of information to the individuals, as well as the handling of this patient group in primary care.