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Association of educ...
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Brunström, MattiasUmeå universitet,Avdelningen för medicin
(author)
Association of education and feedback on hypertension management with risk for stroke and cardiovascular disease
- Article/chapterEnglish2022
Publisher, publication year, extent ...
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2022-02-18
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Informa UK Limited,2022
Numbers
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LIBRIS-ID:oai:gup.ub.gu.se/313983
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https://gup.ub.gu.se/publication/313983URI
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https://doi.org/10.1080/08037051.2022.2041393DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-192773URI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Purpose Education and feedback on hypertension management has been associated with improved hypertension control. This study aimed to assess the effectiveness of such interventions to reduce the risk of stroke and cardiovascular events. Materials and Methods Individuals >= 18 years with a blood pressure (BP) recording in Vasterbotten or Sodermanland County during the study period 2001 to 2009 were included in 108 serial cohort studies, each with 24 months follow-up. The primary outcome was risk of first-ever stroke in Vasterbotten County (intervention) compared with Sodermanland County (control). Secondary outcomes were first-ever major adverse cardiovascular event (MACE), myocardial infarction, and heart failure, as well as all-cause and cardiovascular mortality. All outcomes were analysed using time-to-event data included in a Cox proportional hazards model adjusted for age, sex, hypertension, diabetes, coronary artery disease, atrial fibrillation, systolic BP at inclusion, marital status, and disposable income. Results A total of 121 365 individuals (mean [SD] age at inclusion 61.7 [16.3] years; 59.9% female; mean inclusion BP 142.3/82.6 mmHg) in the intervention county were compared to 131 924 individuals (63.6 [16.2] years; 61.2% female; 144.1/81.1 mmHg) in the control county. A first-ever stroke occurred in 2 823 (2.3%) individuals in the intervention county, and 3 584 (2.7%) individuals in the control county (adjusted hazard ratio 0.96, 95% CI 0.90 to 1.03). No differences were observed for MACE, myocardial infarction or heart failure, whereas all-cause mortality (HR 0.91, 95% CI 0.87 to 0.95) and cardiovascular mortality (HR 0.91, 95% CI 0.85 to 0.98) were lower in the intervention county. Conclusions This study does not support an association between education and feedback on hypertension management to primary care physicians and the risk for stroke or cardiovascular outcomes. The observed differences for mortality outcomes should be interpreted with caution.
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Ng, Nawi,1974Umeå universitet,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,Institutionen för epidemiologi och global hälsa,School of Public Health and Community Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden(Swepub:umu)ngna0002
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Dahlström, JohnUmeå universitet,Avdelningen för medicin(Swepub:umu)jondam00
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Lindholm, Lars H.Umeå universitet,Allmänmedicin(Swepub:umu)lali0003
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Norberg, MargaretaUmeå universitet,Avdelningen för medicin(Swepub:umu)mano0062
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Nyström, Lennarth,1944-Umeå universitet,Institutionen för epidemiologi och global hälsa(Swepub:umu)leny0002
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Weinehall, LarsUmeå universitet,Institutionen för epidemiologi och global hälsa(Swepub:umu)lawe0001
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Carlberg, BoUmeå universitet,Avdelningen för medicin(Swepub:umu)boca0001
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Umeå universitetAvdelningen för medicin
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Related titles
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In:Blood Pressure: Informa UK Limited31:1, s. 31-390803-70511651-1999
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