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Treating to hypertension targets

A McKerracher1

  • 1St Mary's Hospital, Praed Street, London W2 1NY, UK. a.mckerracher@imperial.ac.uk

Heart (British Cardiac Society)
|May 18, 2004
PubMed

Insights

Achieving blood pressure control targets for hypertension is challenging. The Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) demonstrates higher success rates through strict adherence to guidelines and patient-centered care strategies.

Area of Science:

  • Cardiology
  • Hypertension Management
  • Public Health

Background:

  • Blood pressure control in hypertensive patients frequently falls short of British Hypertension Society (BHS) guidelines.
  • Optimal treatment targets for non-diabetic individuals are less than or equal to 140/85 mm Hg.
  • Health survey data from England (1998) indicated low control rates: 8% for men and 11% for women below 140/90 mm Hg.

Purpose of the Study:

  • To investigate factors contributing to successful blood pressure control in hypertensive patients.
  • To compare blood pressure control rates between general population surveys and a specialized trial setting.
  • To identify strategies from the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) that could be applied to primary care.

Main Methods:

  • Analysis of data from the Health Survey for England and the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT).
  • Comparison of blood pressure control rates (< 140/90 mm Hg) in non-diabetic patients.
  • Identification of key elements in the ASCOT protocol associated with improved outcomes.

Main Results:

  • The ASCOT trial achieved significantly higher blood pressure control rates (87% below 140/90 mm Hg) compared to general population surveys.
  • Factors contributing to ASCOT's success include strict protocol adherence, a focus on cardiovascular disease, extended consultation times, and adherence to BHS guidelines for readings.
  • Reinforcement of non-pharmacological advice was also a key component.

Conclusions:

  • Implementing ASCOT's successful strategies, such as enhanced patient-provider interaction and rigorous guideline adherence, may improve hypertension management in primary care.
  • The findings suggest that specific clinical practices can significantly improve blood pressure control rates.
  • Translating these elements to primary care settings presents an opportunity to enhance patient outcomes in hypertension management.

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