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Analysing the concept of diagnostic inertia in hypertension: a cross-sectional study

V Pallares-Carratalá1,2, I Bonig-Trigueros3, A Palazón-Bru4,5

  • 1Health Surveillance Department, Mutual Society of Castellón, Castellón, Spain.

International Journal of Clinical Practice
|May 11, 2016
PubMed

Insights

Diagnostic inertia, the failure to diagnose hypertension, affects 13.3% of patients. Key factors include male gender and older age, while conditions like atrial fibrillation and cardiovascular disease reduce its likelihood.

Area of Science:

  • Cardiology
  • Clinical Research
  • Public Health

Background:

  • Hypertension diagnosis requires timely intervention.
  • Diagnostic inertia (DI) is the failure to diagnose hypertension despite elevated blood pressure readings.
  • Understanding DI's prevalence and associated factors is crucial for improving patient outcomes.

Purpose of the Study:

  • To quantify the prevalence of diagnostic inertia in patients with hypertension.
  • To identify factors associated with diagnostic inertia in clinical practice.

Main Methods:

  • A cross-sectional, observational study of 48,605 patients with at least three blood pressure measurements.
  • Diagnostic inertia was defined as mean blood pressure ≥ 140/90 mmHg without a hypertension diagnosis.
  • Multivariate logistic regression analyzed associations with gender, comorbidities, and physician training (ESCARVAL).

Main Results:

  • Diagnostic inertia was observed in 13.3% of the study population.
  • Factors associated with DI included male gender (OR=1.46) and older age.
  • Atrial fibrillation (OR=0.73), cardiovascular disease (OR=0.77), and ESCARVAL training (OR=0.88) were associated with lower DI.
  • The predictive model demonstrated strong performance (AUC=0.81).

Conclusions:

  • Diagnostic inertia is a prevalent issue in hypertension management.
  • Predictive factors for DI were identified, aiding in risk stratification.
  • Further research can differentiate DI types, improving diagnostic accuracy and patient care.
Abstract

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