Key result
Differences in attending physicians' practice patterns were significantly associated with inadequate blood pressure control, with patients of less aggressive physicians having up to 5.47 times higher odds of uncontrolled hypertension.
Why the study?
Does the attending physician's attitude toward antihypertensive therapy affect inadequate blood pressure control in hypertensive outpatients?
Cross-Sectional (n=256)
No
Does the attending physician's attitude toward antihypertensive therapy affect inadequate blood pressure control in hypertensive outpatients?
Answers are grounded in this paper and cite their sources.
Physicians' attitudes toward intensifying antihypertensive therapy play a crucial role in achieving adequate blood pressure control in outpatients.
Adequate control of blood pressure (BP) is important for preventing hypertensive complications, but it has been reported that many patients remain uncontrolled despite regular care. We studied the factors contributing to inadequate control of BP. A cohort of hypertensive patients (n = 395) was queried in regard to their quality of life (QOL) and drug compliance, and the characteristics of responders (n = 256) were obtained from their clinical records. The achieved level of BP was determined by the mean of at least five readings at five recent visits. The mean age, BP, and body mass index were 73.0 +/- 8.8 years, 139 +/- 12/76 +/- 8 mmHg, and 24.1 +/- 3.5, respectively. There was no significant relation between the BP level and the QOL score. The patients were divided into 6 groups according to their attending physicians (A, B, C, D, E, and F), and the BP levels were compared among the groups. Systolic BPs were higher in the A (143 +/- 13 mmHg) and the F (145 +/- 12 mmHg) groups than in the B (135 +/- 10 mmHg) group, whereas diastolic BPs were similar among the groups. Moreover, increases in therapy occurred at lower BP levels in the B group (158 +/- 13/83 +/- 14 mmHg, n = 14) than in the A group (173 +/- 21/87 +/- 16 mmHg, n = 8). Other characteristics of the clinical background were similar among the groups. Multivariate analysis indicated that inadequate BP control (> or = 140/90 mmHg) was associated with difference of physicians (A, C, D, or F vs. B), number of antihypertensive drugs ( 2 vs. 1), and increases in therapy (vs. no increases in therapy). These results suggest that physicians' attitudes toward antihypertensive therapy play a crucial role in adequate BP control.
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Ono et al. (2003) conducted a cross-sectional in Hypertension (n=256). Attending physician practice patterns (Physician F vs. B) vs. Physician B (more aggressive treatment pattern) was evaluated on Inadequate blood pressure control (≥140/90 mmHg) (OR 5.47, 95% CI 2.17-13.81, p=<0.001). Differences in attending physicians' practice patterns were significantly associated with inadequate blood pressure control, with patients of less aggressive physicians having up to 5.47 times higher odds of uncontrolled hypertension.
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