{
  "abstract": "Objectives Hypertension is a major modifiable risk factor for cardiovascular disease, and timely detection enables interventions that can substantially reduce this risk. General practice, with continuity of care (COC) as one of its core values, plays a pivotal role in hypertension detection. This study aimed to investigate the association between COC and the detection of hypertension in general practice.Design Longitudinal dynamic cohort study.Setting This study used routine care data from 48 Dutch general practices between 2013 and 2022.Participants 106 755 adults without known cardiovascular diseases or risk factors at baseline.Outcome measures The Herfindahl-Hirschman Index, an established measure for COC, was used to calculate both general practitioner (GP)- and team-COC. A multivariable Cox proportional hazard regression model was used to assess the association between COC level (low, intermediate, high) and the incidence of hypertension detection.Results We included 106 755 patients (59.5% female, median age 35 years) in our analysis. The overall incidence rate was 9.42 hypertension diagnoses per 1000 person-years (95% CI 9.20 to 9.64). Compared with low COC, patients receiving intermediate or high GP-COC had a 1.9 (95% CI 1.7 to 2.1) to 4.9 (95% CI 4.4 to 5.4) higher HR of hypertension detection; patients receiving intermediate or high team-COC had a 2.3 (95% CI 2.2 to 2.5) to 7.3 (95% CI 6.8 to 7.8) higher HR of hypertension detection. High personal continuity was associated with up to 8.3 months (95% CI 8.6 to 7.9) earlier detection of hypertension. The association between COC and hypertension detection was dose-dependent.Conclusions This study shows that both GP-COC and team-COC are dose-dependently associated with increased HRs and earlier detection of hypertension in adults without preregistered cardiovascular conditions. Promoting COC contributes to cardiovascular preventive care.",
  "authors": [
    {
      "affiliations": [
        "Department of General Practice, Amsterdam UMC Location VUmc, Amsterdam, Netherlands"
      ],
      "name": "Nick Ryan van der Velde"
    },
    {
      "affiliations": [
        "Department of General Practice, Amsterdam UMC Location VUmc, Amsterdam, Netherlands",
        "Amsterdam Public Health Research Institute, Amsterdam, Netherlands"
      ],
      "name": "Marije T te Winkel"
    },
    {
      "affiliations": [
        "Department of General Practice, Amsterdam UMC Location VUmc, Amsterdam, Netherlands"
      ],
      "name": "Jos P Kanning"
    },
    {
      "affiliations": [
        "Julius Center for Health Sciences and Primary Care, Utrecht, Netherlands",
        "University Medical Centre Utrecht, Utrecht, Netherlands",
        "Utrecht University, Utrecht, Netherlands"
      ],
      "name": "Birgit I Lissenberg-Witte"
    },
    {
      "affiliations": [
        "Amsterdam Public Health Research Institute, Amsterdam, Netherlands",
        "Department of General Practice, Amsterdam UMC, Amsterdam, Netherlands",
        "Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands"
      ],
      "name": "Ralf Harskamp"
    },
    {
      "affiliations": [
        "Department of General Practice, Amsterdam UMC Location VUmc, Amsterdam, Netherlands",
        "Amsterdam Public Health Research Institute, Amsterdam, Netherlands"
      ],
      "name": "Otto R Maarsingh"
    }
  ],
  "title": "Association between continuity of care and detection of hypertension in Dutch general practice: a 10-year cohort study",
  "uid": "f16a36a5-dd76-557d-8e0f-483e2f9917b6"
}