In his Editorial on the primary prevention of cardiovascular disease
(1), Professor Reckless incorrectly states that the management of blood
pressure in patients with hypertension has shown limited improvement
between 1998 and 2008, based on Health Survey for England (HSE) data. In
fact as shown in the table in the 4 years (1994 (2), 1998 (3), 2003 (4)
and 2006 (5)) that HSE focused on cardiovascular disease and associated
risk factors, the rates of awareness, treatment and control have improved
dramatically.
Admittedly relative increases in treatment rates are less than for
lipid-lowering agents but this reflects the low baseline from which the
latter began. Importantly, in the 12 year period shown treatment rates
have almost doubled and control rates have almost trebled.
2. Colhoun HM, Dong W, Poulter NR. Blood pressure screening,
management and control in England; results from the Health Survey for
England 1994. J Hypertens.1998;16:747-753.
3. Primatesta P, Brookes M, Poulter NR. Improved hypertension
management and control.Results from the Health Survey for England 1998.
Hypertension. 2001;38:827-832.
4. Primatesta P, Poulter NR. Improvement in hypertension management
in England: results from the Health Survey for England 2003. J Hypertens.
2006;24:1187-1192.
5. Falaschetti E, Chaudhury M, Mindell J, Poulter NR. Continued
Improvement in Hypertension Management in England: Results from the Health
Survey for England 2006. Hypertension. 2009; 53:480-486
Competing interests:
EF has no competing interest. JM is paid by the NHS Information Centre to work on the Health Survey for England series. PP was an employee of UCL until 2006. She is now full time employed at Novartis Pharma AG. NP has received financial support from several pharmaceutical companies which manufacture either BP-lowering or lipid lowering agents, or both, for consultancy fees, research projects and staff and for arranging and speaking at educational meetings. He holds no stocks and shares in any such companies.
07 April 2011
Emanuela Falaschetti
Senior Research Associate
Jennifer Mindell, Paola Primatesta and Neil Poulter
Rapid Response:
Hypertension Management in England
Dear Sir,
In his Editorial on the primary prevention of cardiovascular disease
(1), Professor Reckless incorrectly states that the management of blood
pressure in patients with hypertension has shown limited improvement
between 1998 and 2008, based on Health Survey for England (HSE) data. In
fact as shown in the table in the 4 years (1994 (2), 1998 (3), 2003 (4)
and 2006 (5)) that HSE focused on cardiovascular disease and associated
risk factors, the rates of awareness, treatment and control have improved
dramatically.
Admittedly relative increases in treatment rates are less than for
lipid-lowering agents but this reflects the low baseline from which the
latter began. Importantly, in the 12 year period shown treatment rates
have almost doubled and control rates have almost trebled.
Yours sincerely
Emanuela Falaschetti
Jennifer Mindell
Paola Primatesta
Neil Poulter
Year Awareness Treated Controlled
%(SE) %(SE) %(SE)
Men
1994 40.0(1.0) 26.2(0.9) 9.2(0.6)
1998 48.2(1.1) 32.9(1.0) 13.1(0.7)
2003 59.7(1.3) 43.1(1.3) 20.6(1.1)
2006 61.9(1.5) 46.9(1.5) 24.3(1.3)
Women
1994 51.4(1.1) 37.5(1.0) 12.1(0.7)
1998 57.7(1.1) 44.0(1.1) 16.2(0.8)
2003 63.9(1.2) 52.4(1.3) 23.0(1.1)
2006 70.9(1.4) 61.6(1.5) 32.4(1.4)
References
1. Reckless. Primary prevention of cardiovascular disease. BMJ. 2011; 342: 291-292
2. Colhoun HM, Dong W, Poulter NR. Blood pressure screening, management and control in England; results from the Health Survey for England 1994. J Hypertens.1998;16:747-753.
3. Primatesta P, Brookes M, Poulter NR. Improved hypertension management and control.Results from the Health Survey for England 1998. Hypertension. 2001;38:827-832.
4. Primatesta P, Poulter NR. Improvement in hypertension management in England: results from the Health Survey for England 2003. J Hypertens. 2006;24:1187-1192.
5. Falaschetti E, Chaudhury M, Mindell J, Poulter NR. Continued Improvement in Hypertension Management in England: Results from the Health Survey for England 2006. Hypertension. 2009; 53:480-486
Competing interests: EF has no competing interest. JM is paid by the NHS Information Centre to work on the Health Survey for England series. PP was an employee of UCL until 2006. She is now full time employed at Novartis Pharma AG. NP has received financial support from several pharmaceutical companies which manufacture either BP-lowering or lipid lowering agents, or both, for consultancy fees, research projects and staff and for arranging and speaking at educational meetings. He holds no stocks and shares in any such companies.