ArticleHigh blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension2015
Why is my hypertensive patient still not controlled?
Article in High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Cascade of care for hypertension among apparently healthy and unhealthy individuals of 25-64 years in the Czech Republic.PloS one · 2024Article
- Prevalence and control of hypertension in the general practice in Italy: updated analysis of a large database.Journal of human hypertension · 2017Article
- Lack of blood pressure control in Italy: room for improvement?High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2015Article
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
unlabelledDespite the well-known obstacles to blood pressure (BP) control, significant improvement can be obtained. Unfortunately more than a third of hypertensive patients remain non-controlled even after improving initiatives. We asked a group of General Practitioners (GPs) why their patients failed to reach the target despite their efforts.
methodsAfter an audit the control rate increased from 50.8 % to 64.1 %. The 18 participating GPs analyzed the 2,674 patients who remained non controlled (no available BP recording in the last year or last available recorded value ≥140/90 mmHg -office BP-, ≥135/85 mmHg -home BP-, ≥130/80 mmHg -ambulatory BP-) and filled a questionnaire about the reasons for patients' non-attendance and for lack of BP control.
resultsBP values were missing in 1,769 (66.1 %) patients; reasons: contact impossible (19 %), contacted, but did not attend (29 %), forgot to check BP (19 %), BP checked at home, but not recorded (10 %), patients cared for by specialists (12 %), the patient is a doctor or a doctor's relative (4 %), other (12 %). Among the other 905 (33.9 %) non-controlled subjects (with recorded BP) 23 % were prescribed with ≥3, and 10 % with ≥4 drugs. Reasons not to increase therapy were: patient choice (29 %), wait and see strategy/patient not stable yet (26 %), increase inappropriate (20 %), others caring for hypertension (9 %), secondary hypertension (5 %), reached maximum possible therapy (4 %), "resistant hypertension" (4 %), forgot to increase therapy (3 %), other (5 %).
conclusionsThe priorities for further improvement are the patients who do not see their doctors (regularly), followed by those unwilling to increase their therapy.
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