Comparing the Documentation of Phosphatidylethanol and Alcohol History in Hypertension Management in Primary Care: A Cross-Sectional Study.

Authors

Anders Norrman, Åsa Thurfjell, Maria Hagströmer, Johanna Adami, Lena Lundh, Jan Hasselström

Published in

Journal of primary care & community health. Volume 17. Pages 21501319261465137. Epub Jul 02, 2026.

Abstract

Introduction/ObjectivesHazardous alcohol use is a modifiable risk factor for hypertension, yet it is often underrecognized in primary care, and the role of Phosphatidylethanol (PEth) testing in documenting alcohol use remains unclear. This study assessed alcohol use documentation using PEth and alcohol history in relation to blood pressure (BP) control and patient characteristics, and examined hazardous alcohol use by both methods in relation to BP control.MethodsAll patients with hypertension from a Swedish primary care centre, routinely using PEth, were included in a cross-sectional study based on electronic medical records. Patients were categorized as having controlled (<140/90 mmHg), uncontrolled (≥140/90 mmHg), or apparent treatment-resistant hypertension (aTRH) (≥140/90 mmHg despite ≥3 antihypertensive drugs). Alcohol documentation and hazardous use were analyzed using PEth 16:0/18:1 values and alcohol history (free-text entries or AUDIT). Group differences were examined using chi-square and one-way ANOVA.ResultsA total of 1,826 patients were included (mean age 71 years; 51.5% women); 35% had controlled hypertension, 50% uncontrolled hypertension, and 16% aTRH. Documentation patterns differed by BP control, sex, age, and comorbidities. PEth was documented more often than alcohol history (56.0% vs. 39.9%, respectively). Women, older individuals, and patients with diabetes more frequently lacked documentation. Hazardous alcohol use was identified in 18.4% using PEth and 7.1% using alcohol history, with no differences across BP control groups. Hazardous use was higher in men by PEth, not alcohol history.ConclusionPEth testing can complement alcohol history in hypertension management, providing clinically relevant information, although its impact on detecting hazardous drinking or improving BP control remains uncertain.

PMID:
42390343
Bibliographic data and abstract were imported from PubMed on 02 Jul 2026.

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