Key result
Physicians changed antihypertensive treatment in 50.8% of uncontrolled hypertensive patients, citing inadequate control in 615 cases.
Cross-Sectional (n=1,614)
Yes
Absolute Event Rate: 50.8% vs 49.2%
Physicians frequently do not intensify antihypertensive treatment in high-risk cardiovascular patients with uncontrolled blood pressure, often because they perceive the blood pressure to be adequately controlled when values are only slightly above the guideline target.
Indicates clinical inertia in uncontrolled hypertension; challenges consensus on intensification yet leaves open targeted interventions.
Physicians do not change antihypertensive treatment in many uncontrolled cardiovascular patients because they considered it unnecessary, especially when the BP values are only slightly above the guideline target. It is possible that the guidelines may be correct, but there is also the possibility that the care by the physicians is appropriate since BP <130/80 mmHg is hard to achieve, and recent reviews suggest there is insufficient evidence to support such a low BP target.
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Banegas et al. (2011) conducted a cross-sectional in Hypertension with previous cardiovascular disease (n=1,614). Antihypertensive treatment changes vs. No treatment change was evaluated on Proportion of patients with uncontrolled hypertension where treatment was not changed. Physicians changed antihypertensive treatment in 50.8% of uncontrolled hypertensive patients, citing inadequate control in 615 cases.
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