PharmacoEconomics & Outcomes News 360 - 27 Apr 2002

Antihypertensive therapyunderused in uncontrolled

hypertensionPrimary-care physicians in the US often do not

provide necessary aggressive treatment for patients withuncontrolled hypertension, as they accept a highersystolic BP value than that recommended in theguidelines, suggest researchers from the US.

They sampled patient visits over a 3-week period in alarge US health system to identify patients withuncontrolled hypertension (n = 231), and surveyedphysicians to assess their attitudes to intensifyingpharmacological treatment for such patients.* Resultsshowed that the average systolic BP of patients duringthe previous 6 months was 152mm Hg and diastolic BPwas 84mm Hg; 94% of patients were receivingantihypertensive medication. Despite all physiciansreporting that they were very familiar or somewhatfamiliar with the JNC VI** guidelines, physicians initiatedor intensified treatment in only 38% of visits. The mostfrequently cited reasons given by physicians for notchanging therapy included satisfaction with patients’ BPvalue, hypertension that was considered onlyborderline, and a need to continue monitoring thepatient before changing therapy.* The study was supported by a grant from Bristol-Myers SquibbCompany, US, with which two of the researchers were affiliated.** Sixth Report of the Joint National Committee on Prevention,Detection, Evaluation, and Treatment of High Blood Pressure

Oliveria SA, et al. Physician-related barriers to the effective management ofuncontrolled hypertension. Archives of Internal Medicine 162: 413-420, 25 Feb2002 800900399

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PharmacoEconomics & Outcomes News 27 Apr 2002 No. 3601173-5503/10/0360-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved