Prediction model for starting antihypertensives in patients with & without CVD
Two papers published in summer 2013 found that the majority of patients started on statins for primary prevention of CVD were not eligible under current guidelines. The aim of this analysis is to investigate what proportion of patients are eligible for antihypertensives and what proportion of those eligible are started on treatment.
Eligiblity for antihypertensives will be based on NICE hypertension guidelines and the Joint British Societies guidelines. These are:
• All patients with persistent blood pressure ≥160/100 mm Hg (a mean of two successive measurements) are eligible for antihypertensive treatment.
• Patients at high risk and persistent blood pressure ≥140/90 mm Hg (a mean of two successive measurements) are eligible for antihypertensive treatment. High risk patients include patients with:
CVA including TIA
Ten year CVD risk ≥20%
Retrospective cohort study of patients in a large database of electronic primary care records to determine which patients are started on antihypertensive treatment.
This doctoral thesis will develop and make use of skills in epidemiology and statistical analysis and in the handling of large datasets of electronic primary care records.
Applicants should hold or realistically expect to obtain at least an Upper Second Class Honours Degree in a relevant health or social science subject and have skills in data analysis.
Alternatively applicants may hold or realistically expect to obtain at least an Upper Second Class Honours Degree in a relevant subject that includes substantial analytic skills such as statistics, mathematics or computing science, but have a demonstrable interest in health and health care.
Self-funded students only
Wu J, Yao GL, Zhu S, Mohammed MA. Marshall T. Patient factors influencing the prescribing of lipid lowering drugs for primary prevention of cardiovascular disease in UK general practice: a national retrospective cohort study PLoS One 2013 8(7): e67611. doi:10.1371/journal.pone.0067611
van Staa TP, Smeeth L, Ng ES, Goldacre B, Gulliford M. The efficiency of cardiovascular risk assessment: do the right patients get statin treatment? Heart. 2013 Nov;99(21):1597-602. doi: 10.1136/heartjnl-2013-303698. Epub 2013 Jun 4