• Mikko Hellgren, Patrik Wennberg, Katarina Hedin, Stefan Jansson, Staffan Nilsson, Gunnar Nilsson, Per Wändell, and Bengtsson BoströmKristinaK0000-0003-0757-5774School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden..
• University Health Care Research Centre, Örebro University Hospital, Örebro, Sweden.
• Scand J Prim Health Care. 2023 Sep 1; 41 (3): 343350343-350.

PurposeTo explore hypertension management in primary healthcare (PHC).DesignStructured interviews of randomly selected PHC centres (PHCCs) from December 2019 to January 2021.SettingSeventy-six PHCCs in eight regions of Sweden.Main Outcome MeasuresStaffing and organization of hypertension care. Methods of measuring blood pressure (BP), laboratory tests, registration of co-morbidities and lifestyle advice at diagnosis and follow-up.ResultsThe management of hypertension varied among PHCCs. At diagnosis, most PHCCs (75%) used the sitting position at measurements, and only 13% routinely measured standing BP. One in three (33%) PHCCs never used home BP measurements and 25% only used manual measurements. The frequencies of laboratory analyses at diagnosis were similar in the PHCCs. At follow-up, fewer analyses were performed and the tests of lipids and microalbuminuria decreased from 95% to 45% (p < 0.001) and 61% to 43% (p = 0.001), respectively. Only one out of 76 PHCCs did not measure kidney function at routine follow-ups. Lifestyle, physical activity, food habits, smoking and alcohol use were assessed in ≥96% of patients at diagnosis. At follow-up, however, there were fewer assessments. Half of the PHCCs reported dedicated teams for hypertension, 82% of which were managed by nurses. There was a great inequality in the number of patients per tenured GP in the PHCCs (median 2500; range 1300-11300) patients.ConclusionsThe management of hypertension varies in many respects between PHCCs in Sweden. This might lead to inequity in the care of patients with hypertension.

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