Association between office visit intervals and long‐term cardiovascular risk in hypertensive patients

Author:

Kim Duon1,Jeong Hyunmook2,Kim Suhyun3ORCID,Shin Ho‐Gyun4,Park Kyun‐Ik4,Lee Seung‐Pyo5,Lee Hee‐Sun5,Lee Ju‐Yeun6,Kim Kwang‐il7,Kang Si‐Hyuck7,Lee Jang Hoon8ORCID,Jang Se Yong8,Lee Ju‐Hee9,Kim Kye Hun10,Cho Jae Yeong10,Park Jae‐Hyeong11,Park Sue K.12,Kim Seungyeon13,Kim Kwangsoo3,Lee Hae‐Young514ORCID

Affiliation:

1. Department of Medicine Seoul National University College of Medicine Seoul South Korea

2. Biomedical Research Institute Seoul National University Hospital Seoul South Korea

3. Transdisciplinary Department of Medicine & Advanced Technology Seoul National University Hospital Seoul South Korea

4. National Evidence‐based Healthcare Collaborating Agency (NECA) Seoul South Korea

5. Department of Internal Medicine Seoul National University Hospital Seoul South Korea

6. College of Pharmacy Seoul National University Seoul South Korea

7. Department of Internal Medicine Seoul National University Bundang Hospital Sungnam South Korea

8. Department of Internal Medicine Kyungpook National University Hospital, School of Medicine Kyungpook National University Daegu South Korea

9. Division of Cardiology Department of Internal Medicine Chungbuk National University Hospital Chungbuk National University College of Medicine Cheongju South Korea

10. Department of Cardiovascular Medicine Chonnam National University Medical School/Hospital Gwangju South Korea

11. Department of Internal Medicine Chungnam National University College of Medicine Daejeon South Korea

12. Department of Preventive Medicine Seoul National University College of Medicine Seoul South Korea

13. College of Pharmacy Dankook University Cheonan South Korea

14. Department of Internal Medicine Seoul National University College of Medicine Seoul South Korea

Abstract

AbstractHypertension is a chronic disease that requires long‐term follow‐up in many patients, however, optimal visit intervals are not well‐established. This study aimed to evaluate the incidences of major cardiovascular events (MACEs) according to visit intervals. We analyzed data from 9894 hypertensive patients in the Korean Hypertension Cohort, which enrolled and followed up 11,043 patients for over 10 years. Participants were classified into five groups based on their median visit intervals (MVIs) during the 4‐year period and MACEs were compared among the groups. The patients were divided into clinically relevant MVIs of one (1013; 10%), two (1299; 13%), three (2732; 28%), four (2355; 24%), and six months (2515; 25%). The median follow‐up period was 5 years (range: 1745 ± 293 days). The longer visit interval groups did not have an increased cumulative incidence of MACE (12.9%, 11.8%, 6.7%, 5.9%, and 4%, respectively). In the Cox proportional hazards model, those in the longer MVI group had a smaller hazard ratio (HR) for MACEs or all‐cause death: 1.77 (95% confidence interval [CI], 1.45–2.17), 1.7 (95% CI: 1.41–2.05), 0.90 (95% CI: 0.74–1.09) and 0.64 (95% CI: 0.52–0.79), respectively (Reference MVI group of 75–104 days). In conclusion, a follow‐up visits with a longer interval of 3–6 months was not associated with an increased risk of MACE or all‐cause death in hypertensive patients. Therefore, once medication adjustment is stabilized, a longer interval of 3–6 months is reasonable, reducing medical expenses without increasing the risk of cardiovascular outcomes.

Funder

Ministry of Health and Welfare

National Evidence-based Healthcare Collaborating Agency

Publisher

Wiley

Subject

Cardiology and Cardiovascular Medicine,Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference27 articles.

1. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019

2. The 2019 statistical yearbook on the usage of medical services by region;Service NHI;Wonju: National Health Insurance Service,2020

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