The proportion of patients classified as having controlled hypertension varied widely from 17.5% to 84.6% depending on which of the five guidelines was applied.
Cross-Sectional (n=876)
Yes
Does the choice of hypertension guideline influence the assessment of hypertension control in patients taking antihypertensive drugs?
Different international hypertension guidelines are highly inconsistent in defining blood pressure control, leading to potentially significant over- or under-treatment.
Abstract Objectives : To investigate and quantify the extent to which variations in guidelines influence assessment of control of hypertension. Design : Cross sectional study. Selected patients had hypertension assessed as controlled or uncontrolled with guidelines from New Zealand, Canada, the United States, Britain, and the World Health Organisation. Setting : 18 general practices in Oxfordshire. Subjects : 876 patients with diagnosed hypertension and taking antihypertensive drugs. Main outcome measures : Proportion of patients with controlled hypertension according to each set of guidelines. Results : The proportion of patients with controlled hypertension varied from 17.5% to 84.6% with the different guidelines after adjustment for the sampling method. All five sets of guidelines agreed on the classification for 31% (277) of the patients. The New Zealand guidelines calculate an absolute risk of a cardiovascular event. When this was taken as the standard half of the patients with uncontrolled hypertension by the United States criteria would be treated unnecessarily and 31% of those classified as having controlled hypertension by the Canadian guidelines would be denied beneficial treatment. Conclusions : Hypertension guidelines are inconsistent in their recommendations and need to make clear the absolute benefits and risks of treatment. Key messages This study applied the recommendations of guidelines from New Zealand, Canada, the United States, Britain, and the WHO to a sample of 879 hypertensive patients The proportion with controlled hypertension varied between 17.5% and 84.6% according to which set of guidelines was followed Overall, the five sets of guidelines agreed for 31% of the patients Hypertension guidelines are inconsistent and unclear on the absolute benefits of treatment
Fahey et al. (1996) conducted a cross-sectional in Hypertension (n=876). Hypertension guidelines (New Zealand, Canada, United States, Britain, WHO) was evaluated on Proportion of patients with controlled hypertension. The proportion of patients classified as having controlled hypertension varied widely from 17.5% to 84.6% depending on which of the five guidelines was applied.