Private patients less likely to be on blood pressure meds

Private patients are losing out when it comes to being treated for high blood pressure — they are significantly less likely to be on medication to control it than those with medical cards, research has found.

Interestingly, the study also found better hypertension control in rural areas, contrary to international evidence showing poorer control in the countryside. The researchers said this finding could be influenced by cheaper costs of visiting GPs in rural areas and rural practices reporting fewer private patients. They said the finding requires further investigation.

The study found the cost of blood pressure treatment was a barrier to seeking it — costs include a GP visit fee for a blood-pressure reading and the cost of long-term subsequent monitoring and medication in the event of a negative finding, for those without a medical card.

In a paper entitled Hypertension prevalence, awareness, treatment and control in the over 50s in Ireland, the researchers from the Irish Longitudinal Study on Ageing (TILDA) in Trinity College Dublin say individuals without medical cards or with private insurance “were less likely to be treated for their hypertension compared with those with medical cards who receive free GP consultations and heavily subsidised medications”.

Lead author Dr Catriona Murphy said the finding suggests a need for policy “towards reducing the financial barrier to healthcare and medication”, with potential “to impact positively on the long-term management of high blood pressure”.

The study also found:

• Those without medical cards or health insurance were 31% less likely to be on medication to control high blood pressure than those with medical cards, taking a number of control factors into account. Private patients were 18% less likely.
• Almost half of those on medication to control hypertension did not have their blood pressure controlled to normal levels.
• 45% with high blood pressure were unaware of their condition, more so among males.
• 64% of the over 50s have high blood pressure, equivalent to 797,000 people.
• In those with high blood pressure, 59% were taking medication to reduce it.

Dr Murphy said the lack of awareness of having high blood pressure was worrying given it was a leading cause of heart disease, stroke, kidney failure and premature death: “People may not know they have it until they develop complications and the damage is done.”

She said awareness needed to be improved through public campaigns rather than GP monitoring.

Principal investigator of TILDA, Professor Rose Anne Kenny, said the prevalence of high blood pressure was “a major public health challenge” that required “a population-wide focus on healthier lifestyles, including weight management, regular physical activity, smoking cessation and restriction of salt and alcohol intake”.

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