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Hypertension control and medication increase in primary care.
1Department of Community and Family Medicine, Jichi Medical School, Yakushiji 3311-1, Minamikawachi, Tochigi, 329-0498, Japan. y.asai@jichi.ac.jp
Journal of Human Hypertension
|June 26, 2002
Summary
Physicians inadequately increased antihypertensive medication for patients with uncontrolled hypertension. Factors like higher blood pressure predicted increases, while physician age and medication variety predicted decreases, impacting hypertension management.
Area of Science:
- Cardiology
- Primary Care Medicine
- Health Services Research
Background:
- Hypertension management remains a challenge, with over half of treated patients experiencing uncontrolled blood pressure.
- Physician prescribing behavior for patients with poorly controlled hypertension is not well understood.
- Effective hypertension control is crucial for reducing cardiovascular disease burden.
Purpose of the Study:
- To investigate whether primary care physicians adjust antihypertensive medication for patients with uncontrolled hypertension.
- To identify predictors of medication adjustments in hypertensive patients.
Main Methods:
- Retrospective cohort study utilizing medical records from primary care clinics in Tochigi, Japan.
- Inclusion of 547 hypertensive patients from 29 randomly selected physicians, with data from 1998 and 1999.
- Analysis of blood pressure control levels (good, fair, poor) and medication prescription changes.
Main Results:
- Physicians increased antihypertensive medication in 28% of poorly controlled patients, compared to 12% in fair and 7% in good control.
- Higher systolic and diastolic blood pressures were associated with increased medication.
- Increased medication was negatively associated with the number of antihypertensive drug types and physician age.
Conclusions:
- Primary care physicians' medication adjustments were insufficient for patients with uncontrolled hypertension.
- Understanding and modifying physician prescribing behavior is essential for improving hypertension control rates.
- Inadequate medication intensification contributes to the burden of uncontrolled hypertension.
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