Physician perception of blood pressure control and treatment behavior in high-risk hypertensive patients: A cross-sectional study
Entity
UAM. Departamento de Medicina Preventiva y Salud Pública y MicrobiologíaPublisher
Public Library of ScienceDate
2011-09-14Citation
10.1371/journal.pone.0024569
Plos One 6.9 (2011): e24569
ISSN
1932-6203 (online)DOI
10.1371/journal.pone.0024569Funded by
Funding for this study was obtained from RECORDATI ESPAÑA, S.L through an unrestricted grant. Krista Lundelin has a ‘‘Rio Hortega’’ research training contract (Expediente CM10/00327) from the Ministry of Science and Innovation (Instituto de Salud Carlos III), Spain GovernmentSubjects
Antihypertensive Agents; Blood Pressure; Cross-Sectional Studies; Physician's Practice Patterns; Hypertension; MedicinaRights
© 2011 Banegas et al.Abstract
Objective: We examined physician perception of blood pressure control and treatment behavior in patients with previous cardiovascular disease and uncontrolled hypertension as defined by European Guidelines. Methods: A cross-sectional study was conducted in which 321 primary care physicians throughout Spain consecutively studied 1,614 patients aged ≥18 years who had been diagnosed and treated for hypertension (blood pressure ≥140/90 mmHg), and had suffered a documented cardiovascular event. The mean value of three blood pressure measurements taken using standardized procedures was used for statistical analysis. Results: Mean blood pressure was 143.4/84.9 mmHg, and only 11.6% of these cardiovascular patients were controlled according to 2007 European Guidelines for Hypertension Management target of <130/80 mmHg. In 702 (49.2%) of the 1426 uncontrolled patients, antihypertensive medication was not changed, and in 480 (68.4%) of these cases this was due to the physicianś judgment that blood pressure was adequately controlled. In 320 (66.7%) of the latter patients, blood pressure was 130-139/80-89 mmHg. Blood pressure level was the main factor associated (inversely) with no change in treatment due to physician perception of adequate control, irrespective of sociodemographic and clinical factors. Conclusions: 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
Files in this item
Google Scholar:Banegas Banegas, José Ramón
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Lundelin, Krista J.
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De La Figuera, Mariano A.
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De La Cruz, Juan José
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Graciani Pérez-Regadera, Auxiliadora
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Rodríguez Artalejo, Fernando
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García Puig, Juan
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