Key result
A simplified antihypertensive treatment algorithm was superior to guideline-based management for achieving target blood pressure at 6 months (64.7% vs 52.7%; absolute difference 12.0%, P=0.026).
Why the study?
Does a simplified treatment algorithm improve the proportion of patients achieving target blood pressure compared to guideline-based management in patients with uncomplicated hypertension?
Population
Patients with uncomplicated hypertension managed in 45 family practices in southwestern Ontario, Canada.
Comparison
Simplified treatment algorithm consisting of… vs Canadian Hypertension Education Program…
Design
RCT, cluster randomization
Follow-up
6 months
Authors
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Simplified algorithms improve BP control in primary care; extends evidence favoring single-pill combinations over complex guidelines.
RCT
Cluster randomization
Yes
Does a simplified treatment algorithm improve the proportion of patients achieving target blood pressure compared to guideline-based management in patients with uncomplicated hypertension?
Effect estimate: Absolute difference 12.0% (95% CI 1.5 to 22.4)
Absolute Event Rate: 64.7% vs 52.7%
Absolute Risk Reduction: 12%
p-value: p=0.026
A simplified antihypertensive algorithm using initial low-dose fixed-dose combination therapy is superior to standard guideline-based practice for achieving blood pressure control.
Feldman et al. (2009) conducted an RCT in Uncomplicated hypertension. Simplified treatment algorithm vs. Canadian Hypertension Education Program guidelines was evaluated on Proportion of patients treated to target blood pressure at 6 months (Absolute difference 12.0%, 95% CI 1.5 to 22.4, p=0.026). A simplified antihypertensive treatment algorithm was superior to guideline-based management for achieving target blood pressure at 6 months (64.7% vs 52.7%; absolute difference 12.0%, P=0.026).
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