Related Experiment Videos
Goal-oriented hypertension management: translating clinical trials to practice
Gregory M Singer1, Munavvar Izhar, Henry R Black
1Rush University Hypertension Service, Rush-Presbyterian St. Luke's Medical Center, Chicago, Ill 60612, USA.
Hypertension (Dallas, Tex. : 1979)
|October 5, 2002
Summary
Goal-oriented management in specialist clinics significantly improved blood pressure (BP) control rates, achieving Sixth Joint National Committee (JNC VI) goals in most patients. Systolic BP control remained challenging, but this approach effectively translates trial results to outpatient practice.
Area of Science:
- Cardiology
- Hypertension Management
- Clinical Practice Research
Background:
- Clinical trials using BP treatment algorithms show superior control rates compared to national data.
- The Sixth Joint National Committee (JNC VI) established specific blood pressure goals for hypertension management.
- Previous studies indicate challenges in achieving target blood pressure levels in routine practice.
Purpose of the Study:
- To evaluate the effectiveness of "goal-oriented management" in achieving JNC VI blood pressure goals in a specialist clinic setting.
- To assess blood pressure control rates after at least one year of follow-up using a non-algorithmic, goal-focused approach.
- To compare achieved control rates with those reported in clinical trials and national surveys.
Main Methods:
- Retrospective analysis of 437 consecutive patients in a specialist clinic.
- Implementation of "goal-oriented management" focusing on specific blood pressure targets without a formal algorithm.
- Assessment of adherence to JNC VI diastolic blood pressure (<90 mm Hg) and systolic blood pressure (<140 mm Hg) goals.
Main Results:
- 63% of patients achieved systolic BP goal, 86% achieved diastolic BP goal, and 59% achieved both.
- Monotherapy was used in 23% of patients; 34% required two drugs, and 37% required three or more.
- Diabetic patients showed lower achievement rates for both JNC VI and stricter ADA/NKF goals.
Conclusions:
- Goal-oriented management significantly improves blood pressure control in outpatient specialist settings.
- Achieving diastolic blood pressure goals is feasible, but systolic blood pressure control remains a challenge.
- This management strategy effectively bridges the gap between clinical trial outcomes and real-world patient care.