The Swedish Primary Care Cardiovascular Database (SPCCD): 74 751 hypertensive primary care patients

Abstract

Objective. To describe the Swedish Primary Care Cardiovascular Database, SPCCD. Design. Longitudinal data from electronic medical records, linked to national registers. Setting. 48 primary healthcare centres in urban (south-western Stockholm) and rural (Skaraborg) regions in Sweden. Subjects. Patients diagnosed with hypertension 2001–2008. Main outcome measures. Blood pressure (BP) and impact of retrieval of data on BP levels, clinical characteristics, co-morbidity and pharmacological treatment. Results. The SPCCD contains 74 751 individuals, 56% women. Completeness of data ranged from > 99% for drug prescriptions to 34% for smoking habits. BP was recorded in 98% of patients during 2001–2008 and in 63% in 2008. Mean BP based on the last recorded value in 2008 was 142 ± 17/80 ± 13 mmHg. Digit preference in BP measurements differed between the two regions, p < 0.001. Antihypertensive drugs were prescribed in primary healthcare to 88% of the patients in 2008; however, when all prescribers were included 96% purchased their drugs. Cardiovascular co-morbidity and diabetes mellitus were present in 28% and 22%, respectively. Conclusion. This large and representative database shows that there is room for improvement of BP control in Sweden. The SPCCD will provide a rich source for further research of hypertension and its complications.

Key Words::

• Blood pressure
• comorbidity
• drug therapy
• hypertension
• primary healthcare
• registries

Acknowledgements

The primary healthcare centres providing data for the studies are cordially thanked. In South West of Stockholm; Alby, Axelsberg, Bredäng, Fittja, Flemingsberg, Fruängen, Gröndal, Hallunda, Huddinge, Liljeholmen, Liseberg, Luna, Segeltorp, Carema i Skogås, Skärholmen, Storvreten, Stuvsta, Sätra, Telgeakuten, Trångsund, Tullinge, Tumba, Tveta, Älvsjö and in Skaraborg; Floby, Falköping (Oden and Mösseberg), Gullspång, Götene, Hjo, Karlsborg, Kvänum, Lidköping (Guldvingen and Ågårdsskogen), Mariestad (Eken and Linden), Nossebro, Skövde (Billingen, Hentorp, Norrmalm and Södra Ryd), Skara, Stenstorp, Tibro, Tidan, Tidaholm, Töreboda and Vara. We are also grateful for valuable technical support from Lennart Pettersson, system engineer, Linus Schiöler, PhD, and Bengt Sjöborg, BSc. Financial support was provided by the Swedish Heart Lung Foundation, Karolinska Institutet, the Health & Medical Care Committee of the Regional Executive Board of the Region Västra Götaland, the Swedish Society of Medicine (Lagerströms and Lysanders foundations), the Skaraborg Research and Development Council, and the Stockholm County Council (Stockholm County Drug and Therapeutics Committee, the Department of Drug Management and Informatics, and the EK-group of Centre for Family and Community Medicine). The SPCCD is endorsed by the Swedish Society for Hypertension, Stroke and Vascular Medicine.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.