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[Hypertension management : from medical inertia to patient autonomy]

Michel Burnier1, Erietta Polychronopoulou1, Grégoire Wuerzner1

  • 1Service de néphrologie et hypertension, chuv, 1011 lausanne.

Revue Medicale Suisse
|September 19, 2018
PubMed

Insights

Despite guidelines, hypertension control remains poor due to therapeutic inertia. Patient empowerment via home monitoring and telemedicine-assisted self-titration may combat this inertia.

Area of Science:

  • Cardiology
  • Hypertension Management
  • Digital Health

Background:

  • Despite extensive guidelines, hypertension control rates remain below 50%, indicating a significant gap in current treatment efficacy.
  • Therapeutic inertia, the failure of clinicians to adjust treatment when indicated, is a persistent barrier to achieving blood pressure targets.
  • This lack of improvement in therapeutic inertia over the past 10-20 years necessitates novel approaches to hypertension management.

Purpose of the Study:

  • To explore strategies for improving hypertension control rates.
  • To address the persistent challenge of therapeutic inertia in clinical practice.
  • To investigate the potential of patient empowerment and digital health tools in managing hypertension.

Main Methods:

  • Review of current hypertension management guidelines and outcomes.
  • Analysis of factors contributing to therapeutic inertia.
  • Exploration of patient empowerment strategies, including home blood pressure monitoring (HBPM).
  • Assessment of telemedicine-supported self-titration protocols as a potential solution.

Main Results:

  • Current hypertension control rates are unacceptably low, highlighting treatment gaps.
  • Therapeutic inertia is a major, long-standing obstacle to effective blood pressure management.
  • Home blood pressure monitoring and telemedicine-supported self-titration show promise for enhancing patient engagement and treatment adherence.

Conclusions:

  • Improving hypertension control requires overcoming therapeutic inertia.
  • Empowering patients with tools like home blood pressure monitoring is crucial.
  • Telemedicine-supported self-titration offers a novel pathway to reduce inertia and improve outcomes.

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