Carlos Escobar1, Vivencio Barrios, F Javier Alonso-Moreno, Miguel Angel Prieto, Francisco Valls, Alberto Calderon, Jose Luis Llisterri. 1. aCardiology Department, Hospital La Paz, Madrid bCardiology Department, Hospital Ramón y Cajal, Madrid cPrimary Care Center Sillería, Toledo dPrimary Care Center Vallobín-La Florida, Oviedo, Asturias ePrimary Care center Benigànim, Valencia fPrimary Care Center Rosa de Luxemburgo, San Sebastián de los Reyes, Madrid gPrimary Care Center Ingeniero Joaquín Benlloch, Valencia, Spain.
Abstract
OBJECTIVE: To determine the therapeutic behavior of primary care physicians in uncontrolled hypertensive patients in Spain during the last decade. METHODS: Data were taken from three cross-sectional surveys aimed to determine the blood pressure (BP) control rates in treated hypertensive patients followed in a setting of primary care in Spain during 2002, 2006, and 2010, respectively. Adequate BP control was globally defined as BP lower than 140/90 mmHg for the hypertensive population in the three studies. In patients with diabetes, chronic kidney disease, or cardiovascular disease, BP control was established as lower than 130/85 mmHg in PRESión arterial en la población Española en los Centros de Atención Primaria (PRESCAP) 2002 and lower than 130/80 mmHg in PRESCAP 2006 and 2010. RESULTS: A total of 12, 754, 10, 520, and 12, 961 patients were included in PRESCAP 2002, 2006, and 2010 studies. Of them, 36.1, 41.4, and 46.3%, respectively, achieved BP targets. In those patients with uncontrolled BP, physicians modified the treatment in 18.3, 30.4, and 41.4% of the cases, respectively (P = 0.0001). The most frequent action taken was the change to another drug in PRESCAP 2002 (47.0%), and the addition of other antihypertensive agent in PRESCAP 2006 and 2010 (46.3 and 55.6%, respectively). Predictors of therapeutic inertia were the physicians' perception of BP control, being on treatment with combined therapy, and the absence of risk factors or cardiovascular disease. CONCLUSION: Although therapeutic inertia has decreased in the last years in primary care setting in Spain, nowadays in nearly 60% of patients with uncontrolled BP, no therapeutic action is actually taken. Therefore, despite a significant improvement, therapeutic inertia still remains a relevant clinical problem in hypertension general practice.
OBJECTIVE: To determine the therapeutic behavior of primary care physicians in uncontrolled hypertensivepatients in Spain during the last decade. METHODS: Data were taken from three cross-sectional surveys aimed to determine the blood pressure (BP) control rates in treated hypertensivepatients followed in a setting of primary care in Spain during 2002, 2006, and 2010, respectively. Adequate BP control was globally defined as BP lower than 140/90 mmHg for the hypertensive population in the three studies. In patients with diabetes, chronic kidney disease, or cardiovascular disease, BP control was established as lower than 130/85 mmHg in PRESión arterial en la población Española en los Centros de Atención Primaria (PRESCAP) 2002 and lower than 130/80 mmHg in PRESCAP 2006 and 2010. RESULTS: A total of 12, 754, 10, 520, and 12, 961 patients were included in PRESCAP 2002, 2006, and 2010 studies. Of them, 36.1, 41.4, and 46.3%, respectively, achieved BP targets. In those patients with uncontrolled BP, physicians modified the treatment in 18.3, 30.4, and 41.4% of the cases, respectively (P = 0.0001). The most frequent action taken was the change to another drug in PRESCAP 2002 (47.0%), and the addition of other antihypertensive agent in PRESCAP 2006 and 2010 (46.3 and 55.6%, respectively). Predictors of therapeutic inertia were the physicians' perception of BP control, being on treatment with combined therapy, and the absence of risk factors or cardiovascular disease. CONCLUSION: Although therapeutic inertia has decreased in the last years in primary care setting in Spain, nowadays in nearly 60% of patients with uncontrolled BP, no therapeutic action is actually taken. Therefore, despite a significant improvement, therapeutic inertia still remains a relevant clinical problem in hypertension general practice.
Authors: Vivencio Barrios; Carlos Escobar; Carmen Suarez; Xavier Garcia-Moll; Francisco Lozano Journal: J Clin Med Date: 2022-06-20 Impact factor: 4.964
Authors: Olga Siga; Barbara Wizner; Barbara Gryglewska; Jolanta Walczewska; Tomasz Grodzicki Journal: J Geriatr Cardiol Date: 2019-01 Impact factor: 3.327