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Physician perception of blood pressure control and treatment behavior in high-risk hypertensive patients: a

José R Banegas1, Krista Lundelin, Mariano de la Figuera

  • 1Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain. joseramon.banegas@uam.es

Plos One
|September 22, 2011
PubMed

Insights

Physicians often undertreat hypertension in cardiovascular patients, perceiving blood pressure as controlled even when guidelines indicate otherwise. This leads to suboptimal treatment, particularly when values are only slightly elevated.

Area of Science:

  • Cardiology
  • Hypertension Management
  • Primary Care Medicine

Background:

  • Cardiovascular disease (CVD) patients with uncontrolled hypertension require optimal management.
  • European Guidelines set strict blood pressure (BP) targets (<130/80 mmHg) for these patients.
  • Physician perception of BP control influences treatment decisions.

Purpose of the Study:

  • To examine physician perception of BP control.
  • To assess treatment behavior in high-risk patients with uncontrolled hypertension.
  • To identify factors influencing treatment adjustments.

Main Methods:

  • Cross-sectional study of 321 Spanish primary care physicians.
  • Consecutive enrollment of 1,614 patients with hypertension and prior CVD.
  • Analysis of mean BP from three standardized measurements.

Main Results:

  • Mean BP was 143.4/84.9 mmHg; only 11.6% met BP targets (<130/80 mmHg).
  • Antihypertensive medication was unchanged in 49.2% of uncontrolled patients.
  • Physician perception of adequate control, especially for BP 130-139/80-89 mmHg, was the primary reason for inaction.

Conclusions:

  • Physicians frequently fail to adjust antihypertensive treatment in uncontrolled CVD patients due to perceived adequacy of BP.
  • This discrepancy highlights a potential gap between clinical guidelines and physician practice.
  • The difficulty in achieving very low BP targets and evolving evidence warrant consideration of current guideline recommendations.
Abstract

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