Publications by authors named "Carel Bakx"
Article Synopsis
- Realistic estimation of the prevalence of primary aldosteronism is crucial for effective health care planning, yet reported rates vary widely due to differences in study designs and populations.
- A review of 39 studies involving over 42,000 hypertensive patients showed prevalence rates between 1% and 29.8%, with significant variability making it hard to determine accurate estimates.
- The study highlights the need for a new prevalence study that considers identified factors influencing reported rates, as inaccurate estimations can affect health care resource allocation.
Background: Symptoms with a high predictive power for colorectal cancer (CRC) do not exist.
Objective: To explore the predictive value of patients' reason for encounter (RFE) in the two years prior to the diagnosis of CRC.
Methods: A retrospective nested case-control study using prospectively collected data from electronic records in general practice over 20 years.
Background: It is generally accepted that pheochromocytoma is associated with an increased cardiovascular risk. This is however not based on studies with an appropriate control group of patients with essential hypertension.
Aim Of The Study: We examined whether patients with pheochromocytoma have an excess cardiovascular morbidity as compared to hypertensive patients.
Background: Although blood pressure measurement is one of the most frequently performed measurements in clinical practice, there are concerns about its reliability. Serial, automated oscillometric blood pressure measurement has the potential to reduce measurement bias and white-coat effect'.
Aim: To study agreement of 30-minute office blood pressure measurement (OBPM) with standardised OBPM, and to compare repeatability.
Purpose: Current office blood pressure measurement (OBPM) is often not executed according to guidelines and cannot prevent the white-coat effect. Serial, automated, oscillometric OBPM has the potential to overcome both these problems. We therefore developed a 30-minute OBPM method that we compared with daytime ambulatory blood pressure.
View Article and Find Full Text PDFUnlabelled: RATIONAL AND AIMS: In recent years, guidelines for treatment of patients with chronic heart failure (CHF) have been updated. Insight in current pharmacological and non-pharmacological treatment of CHF in primary care, which was non-optimal in earlier studies, is limited. We aim to describe current pharmacological and non-pharmacological treatment of CHF in primary care.
View Article and Find Full Text PDFPurpose: To validate two established questionnaires [Morisky and Medication Adherence Report Scale (MARS-5)] for the measurement of medical adherence of patients treated with antihypertensive drugs in primary care in Germany.
Setting: General practitioners (GPs) and their patients in North Rhine-Westphalia, Germany.
Methods: GPs were asked to recruit 12 consecutive patients using blood-pressure-lowering medication for at least 12 months.
Background: Blood pressure does not reach guideline targets in the majority of hypertensive patients. Longitudinal data from general practice records on trends in hypertension management and the influence of guideline changes are lacking.
Objective: To describe the longitudinal impact of guideline revisions on the process and outcome of hypertension management in a primary care based database.
Background: Obese patients are known to have more chronic medical conditions.
Objective: To compare the frequency of encounter for episodes of the 10 most common illnesses in general practice between obese and non-overweight patients.
Methods: Data were derived from the Continuous Morbidity Registration, containing data from four general practices in and around Nijmegen (The Netherlands).
Background: Patients with heart failure often suffer from multiple co-morbid conditions. However, until now only cardiovascular co-morbidity has been well described.
Aims: To understand heart failure in the context of multi-morbidity, by describing the age and sex specific patterns of non-cardiovascular co-morbidity in elderly patients with heart failure in general practice.
Objective: To determine to what extent participants in randomized controlled hypertension trials (RCTs) could be compared to patients with hypertension in general practices.
Study Design And Setting: We analyzed RCTs that had been used in hypertension guidelines or were available for future hypertension guidelines. The characteristics of the participants of these RCTs were compared with those of the patients with hypertension in general practices.
Background: To study the relation between the prescription rates of selected cardiovascular drugs (ACE-inhibitors and Angiotensin receptor blockers, beta-blockers, diuretics, and combinations), sociodemographic factors (age, gender and socioeconomic class) and concomitant diseases (hypertension, coronary heart disease, cerebrovascular accident, heart valve disease, atrial fibrillation, diabetes mellitus and asthma/COPD) among patients with heart failure cared for in general practice.
Methods: Data from the second Dutch National Survey in General Practice, conducted mainly in 2001. In this study the data of 96 practices with a registered patient population of 374.
Context: Cardiovascular disease is common and preventable. Primary care is the preferred setting for individual prevention and management.
Objective: This study analyzed the long-term outcome of cardiovascular risk in a family practice population.
Background: As morbidity registrations generally do not make distinct first and following myocardial infarctions, it is still unclear as to what extent the falling rates of myocardial infarctions are caused by lower incidences of first myocardial infarctions.
Aim: To investigate the incidence of first myocardial infarctions in a general practice population.
Method: Data were taken from the Continuous Morbidity Registration (CMR) Nijmegen, which has been collecting data from four general practices since 1971.
Background: The Stages of Change Model is increasingly used for lifestyle counselling. In general practice, the use of algorithms to measure stage of change is limited, but for successful counselling it is important to know patients' readiness to change.
Aim: To assess the accuracy of the assessment of patients' readiness to change fat consumption, physical activity, and smoking by GPs and general practice registrars.
Objective: To assess the effects of stage-matched nutrition counseling on stages of change and fat intake.
Design: Controlled clinical trial.
Setting: 9 family practices in a family medicine practice network.
Background: Using the Internet may prove useful in providing nutrition counselling and social support for patients with chronic diseases.
Objective: We evaluated the impact of Web-based nutrition counselling and social support on social support measures, anthropometry, blood pressure, and serum cholesterol in patients at increased cardiovascular risk.
Methods: We conducted a randomized controlled trial among patients with increased cardiovascular risk in Canadian family practices.
Background: Studies have shown that the psychosocial determinants attitude, self-efficacy, subjective norm, and health threat are important in predicting intention to change fat consumption. However, the role of habit in relation to these determinants is still largely unknown.
Objective: We aimed to assess whether and how habit influences intention in relation to attitude, self-efficacy, subjective norm, and health threat.
Objective: To examine stage-matched nutrition counseling by family physicians and its effect on dietary intake, anthropometry, and serum lipid levels in patients at elevated risk for cardiovascular disease.
Methods: In this controlled trial, patients randomized to intervention practices received nutrition information following the Stages-of-Change Model, and patients randomized to control practices received usual care.
Results: At both 6 and 12 months after baseline, total fat intake and saturated fat intake declined significantly more in the intervention group than in the control group: -5.