TOPLINE:

In adults without preexisting cardiovascular conditions, continuity of care in general practice by GPs or a team of providers was associated with higher rates of hypertension detection and earlier detection time.

METHODOLOGY:

• Researchers conducted a longitudinal dynamic cohort study using routine care data from 48 Dutch general practices between 2013 and 2022 to assess the link between continuity of care and hypertension detection.
• They included 106,755 adults (median age, 35 years; 59.5% women) without known cardiovascular diseases or risk factors at baseline.
• Continuity of care was measured using the Herfindahl-Hirschman Index (HHI), calculated separately for all GP consultations and team consultations (all GP consultations plus face-to-face consultations with other healthcare providers such as nurses and assistants). HHI measures were divided into tertiles of continuity of care: low, intermediate, and high.
• Hypertension detection was based on the date of the first recorded hypertension episode using primary care codes. Participants were followed up for a median of 93 months.
• The incidence of hypertension and the association between the level of continuity of care and time to hypertension detection were assessed.

TAKEAWAY:

• The overall incidence rate of hypertension diagnoses was 9.42 per 1000 person-years (95% CI, 9.20-9.64) over 754,144.7 person-years of follow-up; the rates were comparable between continuity of care by GPs and a team of providers.
• Patients receiving intermediate or high vs low continuity of care by GPs had higher rates of hypertension detection (hazard ratio [HR] ranging from 1.9 to 4.9; P < .001 for all).
• Patients receiving intermediate or high vs low continuity of care by teams of practitioners had a higher risk for hypertension detection (intermediate: adjusted HR, 2.3; P < .001; high: adjusted HR, 7.3; P < .001).
• High team-continuity of care was associated with hypertension detection on average 8.3 months earlier (95% CI, 7.9-8.6) compared with low team-continuity of care (restricted mean survival time, 109.7 vs 118.0 months).

IN PRACTICE:

"[The study] findings highlight the clinical relevance of fostering COC [continuity of care], even in relatively young or low-risk patients. We advocate for strengthening COC within the framework of preventive cardiovascular care in general practice," the authors wrote.

SOURCE:

This study was led by Nick Ryan van der Velde, Department of General Practice, Amsterdam UMC, Amsterdam, Netherlands. It was published online on March 23, 2026, in BMJ Open.

LIMITATIONS:

There was no consensus on the measures of continuity of care. Underreporting or overreporting by GPs may have resulted in an underestimation or overestimation of the actual effects. The findings may not be generalisable beyond healthcare systems similar to the Dutch primary care.

DISCLOSURES:

Two authors reported receiving support from the Stichting Beroepsopleiding Huisartsen in Netherlands; this organisation was not involved in the study. No competing interests were declared by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.