Differences between private and public primary health care centers and differences between men and women in antihypertensive care and cardiovascular prevention in all patients with hypertension treated in primary care in Stockholm County, Sweden
Abstract Aims To study differences in cardiovascular prevention and hypertension management in primary care in men and women, with comparisons between public and privately operated primary health care (PHC). Methods We used register data from Region Stockholm on collected prescribed medication and r...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12875-025-02716-1 |
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| author | Per Wändell Anders Norrman Julia Eriksson Charlotte Ivarsson Hrafnhildur Gudjonsdottir Maria Hagströmer Lena Lundh Jan Hasselström Boel Brynedal Christina Sandlund Axel C. Carlsson |
| author_facet | Per Wändell Anders Norrman Julia Eriksson Charlotte Ivarsson Hrafnhildur Gudjonsdottir Maria Hagströmer Lena Lundh Jan Hasselström Boel Brynedal Christina Sandlund Axel C. Carlsson |
| author_sort | Per Wändell |
| collection | DOAJ |
| description | Abstract Aims To study differences in cardiovascular prevention and hypertension management in primary care in men and women, with comparisons between public and privately operated primary health care (PHC). Methods We used register data from Region Stockholm on collected prescribed medication and registered diagnoses, to identify patients aged 30 years and above with hypertension. Age-adjusted logistic regression was used to calculate odds ratios (ORs) with 99% confidence intervals (99% CIs) using public PHC centers as referents. Results In total, 119,267 patients with a registered hypertension diagnosis at their primary care center were included; 58,239 men and 61,028 women. In terms of co-morbidities and medications, there were some differences between privately and publicly run PHC: registered diagnosis of dementia, which was higher at private PHC, age-adjusted OR 1.80 (1.24–2.69). For lifestyle counseling, privately run PHC had a higher rate of registered counseling for tobacco 1.17 (1.06–1.29), physical activity 1.13 (1.06–1.17), unhealthy diet 1.08 (1.04–1.13), and counseling according to highest prioritized level of advice stated by national guidelines 1.14 (1.09–1.18). Differences in comorbidities between men and women were found, with higher frequencies of coronary heart disease, congestive heart failure, atrial fibrillation, stroke, diabetes, and gout among men. Regarding antihypertensive treatment, women received less treatment of calcium channel blockers and ACE inhibitors, but more of angiotensin receptor blockers. Conclusions These findings highlight the need for targeted preventive efforts in PHC, especially for male patients, to address disparities in cardiovascular health outcomes. Small differences in preventive measures between public and privately run PHC suggest generally consistent care across healthcare ownership models. |
| format | Article |
| id | doaj-art-2cdb30732f0d4d9bbf36503e809e6f77 |
| institution | Kabale University |
| issn | 2731-4553 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj-art-2cdb30732f0d4d9bbf36503e809e6f772025-01-26T12:45:55ZengBMCBMC Primary Care2731-45532025-01-012611810.1186/s12875-025-02716-1Differences between private and public primary health care centers and differences between men and women in antihypertensive care and cardiovascular prevention in all patients with hypertension treated in primary care in Stockholm County, SwedenPer Wändell0Anders Norrman1Julia Eriksson2Charlotte Ivarsson3Hrafnhildur Gudjonsdottir4Maria Hagströmer5Lena Lundh6Jan Hasselström7Boel Brynedal8Christina Sandlund9Axel C. Carlsson10Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska InstitutetDivision of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska InstitutetDivision of Biostatistics, Institute of Environmental Medicine, Karolinska InstitutetAcademic Primary Health Care Centre, Stockholm RegionCentre for Epidemiology and Community Medicine, Region StockholmAcademic Primary Health Care Centre, Stockholm RegionDivision of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska InstitutetDivision of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska InstitutetCentre for Epidemiology and Community Medicine, Region StockholmDivision of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska InstitutetDivision of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska InstitutetAbstract Aims To study differences in cardiovascular prevention and hypertension management in primary care in men and women, with comparisons between public and privately operated primary health care (PHC). Methods We used register data from Region Stockholm on collected prescribed medication and registered diagnoses, to identify patients aged 30 years and above with hypertension. Age-adjusted logistic regression was used to calculate odds ratios (ORs) with 99% confidence intervals (99% CIs) using public PHC centers as referents. Results In total, 119,267 patients with a registered hypertension diagnosis at their primary care center were included; 58,239 men and 61,028 women. In terms of co-morbidities and medications, there were some differences between privately and publicly run PHC: registered diagnosis of dementia, which was higher at private PHC, age-adjusted OR 1.80 (1.24–2.69). For lifestyle counseling, privately run PHC had a higher rate of registered counseling for tobacco 1.17 (1.06–1.29), physical activity 1.13 (1.06–1.17), unhealthy diet 1.08 (1.04–1.13), and counseling according to highest prioritized level of advice stated by national guidelines 1.14 (1.09–1.18). Differences in comorbidities between men and women were found, with higher frequencies of coronary heart disease, congestive heart failure, atrial fibrillation, stroke, diabetes, and gout among men. Regarding antihypertensive treatment, women received less treatment of calcium channel blockers and ACE inhibitors, but more of angiotensin receptor blockers. Conclusions These findings highlight the need for targeted preventive efforts in PHC, especially for male patients, to address disparities in cardiovascular health outcomes. Small differences in preventive measures between public and privately run PHC suggest generally consistent care across healthcare ownership models.https://doi.org/10.1186/s12875-025-02716-1Antihypertensive agentsComorbidityHypertensionLifestyle risk reductionCounselingPrivate practice |
| spellingShingle | Per Wändell Anders Norrman Julia Eriksson Charlotte Ivarsson Hrafnhildur Gudjonsdottir Maria Hagströmer Lena Lundh Jan Hasselström Boel Brynedal Christina Sandlund Axel C. Carlsson Differences between private and public primary health care centers and differences between men and women in antihypertensive care and cardiovascular prevention in all patients with hypertension treated in primary care in Stockholm County, Sweden BMC Primary Care Antihypertensive agents Comorbidity Hypertension Lifestyle risk reduction Counseling Private practice |
| title | Differences between private and public primary health care centers and differences between men and women in antihypertensive care and cardiovascular prevention in all patients with hypertension treated in primary care in Stockholm County, Sweden |
| title_full | Differences between private and public primary health care centers and differences between men and women in antihypertensive care and cardiovascular prevention in all patients with hypertension treated in primary care in Stockholm County, Sweden |
| title_fullStr | Differences between private and public primary health care centers and differences between men and women in antihypertensive care and cardiovascular prevention in all patients with hypertension treated in primary care in Stockholm County, Sweden |
| title_full_unstemmed | Differences between private and public primary health care centers and differences between men and women in antihypertensive care and cardiovascular prevention in all patients with hypertension treated in primary care in Stockholm County, Sweden |
| title_short | Differences between private and public primary health care centers and differences between men and women in antihypertensive care and cardiovascular prevention in all patients with hypertension treated in primary care in Stockholm County, Sweden |
| title_sort | differences between private and public primary health care centers and differences between men and women in antihypertensive care and cardiovascular prevention in all patients with hypertension treated in primary care in stockholm county sweden |
| topic | Antihypertensive agents Comorbidity Hypertension Lifestyle risk reduction Counseling Private practice |
| url | https://doi.org/10.1186/s12875-025-02716-1 |
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