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Sökning: onr:"swepub:oai:DiVA.org:lnu-81314" > Burden of cardiovas...

  • Streit, SvenUniversity of Bern, Switzerland (författare)

Burden of cardiovascular disease across 29 countries and GPs' decision to treat hypertension in oldest-old.

  • Artikel/kapitelEngelska2018

Förlag, utgivningsår, omfång ...

  • 2018-01-25
  • Taylor & Francis,2018
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:lnu-81314
  • https://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-81314URI
  • https://doi.org/10.1080/02813432.2018.1426142DOI
  • https://lup.lub.lu.se/record/a2f987ec-a080-4df9-9903-a01246053ef5URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • OBJECTIVES: We previously found large variations in general practitioner (GP) hypertension treatment probability in oldest-old (>80 years) between countries. We wanted to explore whether differences in country-specific cardiovascular disease (CVD) burden and life expectancy could explain the differences.DESIGN: This is a survey study using case-vignettes of oldest-old patients with different comorbidities and blood pressure levels. An ecological multilevel model analysis was performed.SETTING: GP respondents from European General Practice Research Network (EGPRN) countries, Brazil and New Zeeland.SUBJECTS: This study included 2543 GPs from 29 countries.MAIN OUTCOME MEASURES: GP treatment probability to start or not start antihypertensive treatment based on responses to case-vignettes; either low (<50% started treatment) or high (≥50% started treatment). CVD burden is defined as ratio of disability-adjusted life years (DALYs) lost due to ischemic heart disease and/or stroke and total DALYs lost per country; life expectancy at age 60 and prevalence of oldest-old per country.RESULTS: Of 1947 GPs (76%) responding to all vignettes, 787 (40%) scored high treatment probability and 1160 (60%) scored low. GPs in high CVD burden countries had higher odds of treatment probability (OR 3.70; 95% confidence interval (CI) 3.00-4.57); in countries with low life expectancy at 60, CVD was associated with high treatment probability (OR 2.18, 95% CI 1.12-4.25); but not in countries with high life expectancy (OR 1.06, 95% CI 0.56-1.98).CONCLUSIONS: GPs' choice to treat/not treat hypertension in oldest-old was explained by differences in country-specific health characteristics. GPs in countries with high CVD burden and low life expectancy at age 60 were most likely to treat hypertension in oldest-old. Key Points  • General practitioners (GPs) are in a clinical dilemma when deciding whether (or not) to treat hypertension in the oldest-old (>80 years of age).  • In this study including 1947 GPs from 29 countries, we found that a high country-specific cardiovascular disease (CVD) burden (i.e. myocardial infarction and/or stroke) was associated with a higher GP treatment probability in patients aged >80 years.  • However, the association was modified by country-specific life expectancy at age 60. While there was a positive association for GPs in countries with a low life expectancy at age 60, there was no association in countries with a high life expectancy at age 60.  • These findings help explaining some of the large variation seen in the decision as to whether or not to treat hypertension in the oldest-old.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Gussekloo, JacobijnLeiden University Medical Center, Netherlands (författare)
  • Burman, Robert AVennesla Primary Health Care Centre, Norway (författare)
  • Collins, ClaireIrish College of General Practitioners, Ireland (författare)
  • Kitanovska, Biljana GerasimovskaUniversity St. Cyril and Metodius, Macedonia,The Saints Cyril and Methodius University of Skopje (författare)
  • Gintere, SandraRiga Stradiņs University, Latvia (författare)
  • Gómez Bravo, RaquelUniversity of Luxembourg, Luxembourg (författare)
  • Hoffmann, KathrynMedical University of Vienna, Austria (författare)
  • Iftode, ClaudiaSano Med West Private Clinic , Romania,Timis Society of Family Medicine (författare)
  • Johansen, Kasper LDanish College of General Practitioners , Denmark (författare)
  • Kerse, NgaireUniversity of Auckland, New Zealand (författare)
  • Koskela, Tuomas HUniversity of Tampere, Finland (författare)
  • Peštić, Sanda KreitmayerUniversity of Tuzla, Bosnia and Herzegovina (författare)
  • Kurpas, DonataWroclaw Medical University, Poland (författare)
  • Mallen, Christian DKeele University, UK (författare)
  • Maisonneuve, HubertUniversity of Geneva, Switzerland,University of Geneva Medical School (författare)
  • Merlo, ChristophInstitute of Primary and Community Care Lucerne (IHAM), Switzerland (författare)
  • Mueller, YolandaInstitute of Family Medicine Lausanne (IUMF), Switzerlan,Lausanne University Hospital (författare)
  • Muth, ChristianeInstitute of General Practice Goethe-University, Germany (författare)
  • Ornelas, Rafael HHospital Israelita Albert Einstein, Brazil (författare)
  • Šter, Marija PetekUniversity of Ljubljana, Slovenia (författare)
  • Petrazzuoli, FerdinandoLund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups,National Italian Society of Medical Education In General Practice,SNAMID (National Society of Medical Education in General Practice), Italy;Lund University, Sweden(Swepub:lu)med-fpz (författare)
  • Rosemann, ThomasUniversity of Zurich, Switzerland,University Hospital of Zurich (författare)
  • Sattler, MartinSSLMG - Societé Scientifique Luxembourgois en Medicine generale, Luxembourg (författare)
  • Švadlenková, ZuzanaOrdinace Řepy, s.r.o, Prague, Czech Republic (författare)
  • Tatsioni, AthinaUniversity of Ioannina, Greece (författare)
  • Thulesius, HansLund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups,Lund University, Sweden;Region Kronoberg, Sweden(Swepub:lu)smi-hth (författare)
  • Tkachenko, VictoriaInstitute of Family Medicine at Shupyk National Medical Academy of Postgraduate Education, Ukraine,Shupyk National Healthcare University of Ukraine (författare)
  • Torzsa, PeterSemmelweis University, Hungary (författare)
  • Tsopra, RosyLIMICS-INSERM, France;St James's University Hospital, UK,Institut Gustave Roussy (författare)
  • Tuz, CananKemaliye Town Hospital, Turkey;Erzincan University, Turkey (författare)
  • Verschoor, MarjoleinUniversity of Bern, Switzerland (författare)
  • Viegas, Rita P ANOVA Medical School, Portugal,NOVA University Lisbon (författare)
  • Vinker, ShlomoTel Aviv University, Israel (författare)
  • de Waal, Margot W MLeiden University Medical Center, Netherlands (författare)
  • Zeller, AndreasUniversity of Basel, Switzerland (författare)
  • Rodondi, NicolasUniversity of Bern, Switzerland;Bern University Hospital, Switzerland (författare)
  • Poortvliet, Rosalinde K ELeiden University Medical Center, Netherlands (författare)
  • University of Bern, SwitzerlandLeiden University Medical Center, Netherlands (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Scandinavian Journal of Primary Health Care: Taylor & Francis36:1, s. 89-980281-34321502-7724

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