high blood pressure high cholesterol hypercholesterolemia Hypertension
Conditions
Interventions
The general practitioners (GPs) of the practices in the intervention group will
actively withdraw medication in patients who do not need pharmacological
treatment according to the guideline CVRM 201
Sponsors
Zorgonderzoek Nederland (ZON)
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: • Age 40 to 70 years; • Prescription of antihypertensive medication and/or lipid-lowering drugs for hypertension and/or hypercholesterolemia during the last 12 months (using ATC codes: C02, C03, C07, C08, C09, C10).
Exclusion criteria
Exclusion criteria: • Cardiovascular disease (ICPC codes: K74, K75, K76, K89, K90.03, K91, K92.01 and K99.01); • Use of platelet aggregation inhibitors (heparin excluded) (ATC code: B01AC); • Use of antihypertensive medication for another reason than prevention of CVD; • Familial hypercholesterolemia/lipidemia (ICPC code: T93.04); • Patients with a current SBP >180 mmHg, or a SBP >180 mmHg before the start of medication; • Patients with a current TC/HDL ratio >8, or a TC/HDL ratio >8 before the start of medication; • Patients with a 10-year CVD risk >16% • 10-year CVD risk of 10-16%, based on the 2011 risk table, in combination with at least one additional major risk-increasing factor; • 10-year CVD risk of 10-16%, based on the 2011 risk table, in combination with two or more additional minor risk-increasing factors; • 10-year CVD risk of 10-16%, based on the 2011 risk table, in combination with one additional minor risk-increasing factor and an SBP >140 mmHg and/or LDL >2.5 mmol/L.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome measure is the change in 10-year CVD risk according to the risk table from the guideline CVRM 2011. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary outcome measures are quality of life (EQ-5D + VAS), (CVD related) mortality, cardiovascular events and side effects related to withdrawal of medication or use of medication. Other outcome measures are related to modifiable risk factors, such as smoking behaviour (smoking behaviour questionnaire), physical activity (SQUASH), alcohol consumption, eating habits (Standard nutrition questionnaire of Dutch common health services), systolic blood pressure (SBP), ratio of total cholesterol/HDL-cholesterol (TC/HDL ratio) in blood, Body Mass Index (body weight and height), and waist circumference. | — |
Countries
Netherlands
Outcome results
None listed