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[False non-response in hypertensive patients treated in general practice]

P Tschudi1, D Conen, J Baumann

  • 1Institut für Hausarztmedizin, Universität Basel. Peter.Tschudi@unibas.ch

Praxis
|July 4, 2008
PubMed

Insights

Many hypertensive patients exhibit elevated blood pressure despite treatment. False non-response, characterized by normal ambulatory blood pressure, is common and linked to female gender and absence of diabetes mellitus.

Area of Science:

  • Cardiology
  • Hypertension Management
  • Primary Care Medicine

Context:

  • Essential arterial hypertension remains a significant public health concern.
  • Many patients treated for hypertension still present with elevated office blood pressure readings.
  • Accurate assessment of treatment response is crucial for effective hypertension management.

Purpose:

  • To investigate the prevalence and predictors of 'False Non-Response' to antihypertensive treatment in primary care.
  • To differentiate between true non-response and masked hypertension using ambulatory blood pressure monitoring.
  • To identify patient characteristics associated with false non-response.

Summary:

  • A study of 41 primary care patients with treated essential arterial hypertension and elevated office blood pressure (>140/90 mmHg) utilized 24-hour ambulatory blood pressure measurement.
  • Patients were classified into those with sustained hypertension (office and ambulatory) and 'False Non-Response' (elevated office BP, normal ambulatory BP <135/85 mmHg).
  • Female gender (67% vs. 23%) was significantly associated with false non-response, while diabetes mellitus (7% vs. 39%) predicted sustained hypertension.

Impact:

  • False non-response to antihypertensive treatment is prevalent in primary care settings.
  • Ambulatory blood pressure monitoring is essential for accurate diagnosis in patients with elevated office readings.
  • Identifying female patients without diabetes as a group at higher risk for false non-response can guide further diagnostic and therapeutic strategies.

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