Earlier studies have proposed that the sex of the patient and the physician may influence if target blood pressure is reached. We investigated the associations between the sex of the patient and the physician, and achieved target blood pressure in a large unselected cohort of hypertensive patients.Design and method:
This cross-sectional cohort study in the Swedish primary Care Cardiovascular Database (SPCCD) includes 16 248 patients with hypertension treated in primary health care in Stockholm in 2006–2008. The three last blood pressure measurements during the time period was analyzed and the patients were grouped female/male with all female physician visits, all male physician visits, and visits including both female and male physician visits (mixed physicians). The blood pressure measurement of the last visit was used for analysis and was <140/90 mmHg. The regression model and odds ratio for achieved target blood pressure was adjusted for age, diabetes mellitus, and cardiovascular comorbidities.Results:
In 15 465 patients (8994 female and 6471 male) the sex of the physician was known. Female patients were older and had less diabetes mellitus, ischemic heart disease, and cerebrovascular disease than males (table). Target blood pressure was achieved in 36.9% of the patients visiting male physicians, 33.5% of the patients visiting female physicians, and 31.6% of the patients visiting mixed physicians (p < 0.0001 for all difference between groups). Male patients visiting a female, compared to a male physician, had a lower likelihood of reaching target blood pressure. Male patients visiting a male physician, compared to mixed physicians visits, had a higher likelihood of reaching target blood pressure (figure). In female patients the sex of the physician and the probability of reaching target blood pressure were not associated.Conclusions:
The probability of reaching target blood pressure was associated with the sex of the physician in male but not in female hypertensive patients. Best results were observed in male patients with male physicians while the worst results were seen with mixed physicians.