Evidence map›Paper›PMID 18784735›Full record

ArticleJournal of human hypertension2009

Reasons for therapeutic inertia when managing hypertension in clinical practice in non-Western countries.

P Ferrari, National Coordinators for the Reasons for not Intensifying Antihypertensive Treatment (RIAT) trial12

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of human hypertension, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
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  6. Trial
  7. Article
  8. Observational
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  10. Article
  11. Management of Hypertension in the Asia-Pacific Region: A Structured Review.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2024
    Review
  12. Article
  13. Article
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  16. Article
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  19. São Paulo call to action for the prevention and control of high blood pressure: 2020.Journal of clinical hypertension (Greenwich, Conn.) · 2019
    Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

P FerrariDepartment of Nephrology, School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Perth, Australia. paolo.ferrari@health.wa.gov.au
National Coordinators for the Reasons for not Intensifying Antihypertensive Treatment (RIAT) trial12

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Insufficient awareness of hypertension guidelines by physicians may be an impediment to achieving adequate blood pressure (BP) control rates in clinical practice. We therefore conducted an open intervention survey among primary care physicians in 1596 centres from 16 countries in four different continents to prospectively assess what is the BP goal defined by physicians for individual patients and what are the reasons for not intensifying antihypertensive treatment when BP goals are not achieved. Enrolled patients (N=35,302) were either not treated to goal (N=22,887) or previously untreated (N=12,250). Baseline systolic and diastolic BP averaged 159/95+/-15/12 mm Hg. BP goals defined by physicians averaged 136+/-6 mm Hg for systolic and 86+/-5 mm Hg for diastolic BP. Patients' individual risk stratification determined BP goals. At last visit BP averaged 132/81+/-11/8 mm Hg and values of <or=140/90 were reached in 92% of untreated and 80% of previously uncontrolled treated hypertensives. The main reasons for not intensifying antihypertensive treatment when BP remained above goal were the assumption that the time after starting the new drug was too short to attain its full effect, the satisfaction with a clear improvement of BP or with a BP nearing the goal, and the acceptance of good self-measurements. In this open intervention program in primary care, a large proportion of patients achieved recommended BP goals. The belief that a clear improvement in BP is acceptable and that the full drug effect may take up to several weeks to be reached are frequent reasons for treatment inertia when goals are not achieved.

Indexed as

Attitude of Health PersonnelDelivery of Health CareDeveloping CountriesHealth Knowledge, Attitudes, PracticePractice Patterns, Physicians'Primary Health CareAgedAntihypertensive AgentsAwarenessBlood PressureClinical CompetenceFemaleGoalsGuideline AdherenceHealth Care SurveysHumansAntihypertensive Agents

Identifiers

PMID18784735

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.