Chung-Sheng Lin1, Yung-Hua Chu2, Yi-Jen Hung3, Du-Yi Lee4, Cheng-Yun Chen5. 1. Department of Internal Medicine, Chung Shan Medical University Hospital and School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 2. Department of Cardiology, Taichung Hospital, Taichung, Taiwan; 3. Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan; 4. Department of Internal Medicine, Cheng Ching Hospital, Taichung, Taiwan; 5. Department of Internal Medicine, Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
Abstract
BACKGROUND: Hypertension control is of the utmost importance for reducing cardiovascular risk. In Taiwan, the hypertension control rate of the general population is low (25%). We investigated the factors affecting outpatient hypertension control to determine whether the low control rate stems from clinician unawareness or inadequate public education. METHODS: Hypertensive patients were recruited between 2003 and 2004 by 13 cardiologists and 9 non-cardiologists from 19 hospitals distributed across four geographical areas of Taiwan. Each clinician recruited 100 consecutive patients from outpatient clinics and reported their drug prescriptions, co-morbidities, and blood pressure (BP) levels. Data were analyzed using the chi square test and multivariate logistic regression analyses. RESULTS: Of the 2145 enrolled patients, 63% attained the BP goal of < 140/90 mmHg. BP control rates were higher in older patients, and in patients who were treated by cardiologists and at medical centers. The control rate of high risk co-morbidity patients (BP goal of < 130/80 mmHg) was 36%, which was significantly lower than the 62% control rate of low risk patients (BP goal of < 140/90 mmHg). Cardiologists achieved higher BP control rates (65% vs. 60%; p = 0.0039), and prescribed more combination regimens (p < 0.0001) and beta blockers than non-cardiologists. Overall, 63% of patients received combination therapy. Calcium channel blockers were the most commonly prescribed antihypertensive drugs, followed by beta blockers, angiotensin receptor blockers, diuretics, and angiotensin-converting enzyme inhibitors. CONCLUSIONS: Two-thirds of the entire study population received combination therapy, although BP control rate is still less than optimal in the high risk patients. Ultimately, a more aggressive strategy is strongly encouraged for patients considered to be at high risk. KEY WORDS: Combination therapy; Hypertension control rate; Prescribing habit.
BACKGROUND:Hypertension control is of the utmost importance for reducing cardiovascular risk. In Taiwan, the hypertension control rate of the general population is low (25%). We investigated the factors affecting outpatienthypertension control to determine whether the low control rate stems from clinician unawareness or inadequate public education. METHODS:Hypertensivepatients were recruited between 2003 and 2004 by 13 cardiologists and 9 non-cardiologists from 19 hospitals distributed across four geographical areas of Taiwan. Each clinician recruited 100 consecutive patients from outpatient clinics and reported their drug prescriptions, co-morbidities, and blood pressure (BP) levels. Data were analyzed using the chi square test and multivariate logistic regression analyses. RESULTS: Of the 2145 enrolled patients, 63% attained the BP goal of < 140/90 mmHg. BP control rates were higher in older patients, and in patients who were treated by cardiologists and at medical centers. The control rate of high risk co-morbidity patients (BP goal of < 130/80 mmHg) was 36%, which was significantly lower than the 62% control rate of low risk patients (BP goal of < 140/90 mmHg). Cardiologists achieved higher BP control rates (65% vs. 60%; p = 0.0039), and prescribed more combination regimens (p < 0.0001) and beta blockers than non-cardiologists. Overall, 63% of patients received combination therapy. Calcium channel blockers were the most commonly prescribed antihypertensive drugs, followed by beta blockers, angiotensin receptor blockers, diuretics, and angiotensin-converting enzyme inhibitors. CONCLUSIONS: Two-thirds of the entire study population received combination therapy, although BP control rate is still less than optimal in the high risk patients. Ultimately, a more aggressive strategy is strongly encouraged for patients considered to be at high risk. KEY WORDS: Combination therapy; Hypertension control rate; Prescribing habit.
Authors: William C Cushman; Charles E Ford; Jeffrey A Cutler; Karen L Margolis; Barry R Davis; Richard H Grimm; Henry R Black; Bruce P Hamilton; Joanne Holland; Chuke Nwachuku; Vasilios Papademetriou; Jeffery Probstfield; Jackson T Wright; Michael H Alderman; Robert J Weiss; Linda Piller; Judy Bettencourt; Sandra M Walsh Journal: J Clin Hypertens (Greenwich) Date: 2002 Nov-Dec Impact factor: 3.738