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Lowered blood pressure targets identify new, uncontrolled hypertensive cases: patient characteristics and
Naphassanan Charoensab1, Kanokporn Pinyopornpanish1, Phaviga Thangsuk2
1Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawarorot Rd, Sriphum, Muang, Chiang Mai, 50200, Thailand.
Insights
New hypertension guidelines significantly increased uncontrolled blood pressure cases. Focusing on weight reduction and medication adherence is crucial for managing hypertension effectively.
Area of Science:
- Cardiology
- Public Health
- Internal Medicine
Background:
- New hypertension guidelines recommend blood pressure (BP) below 130/80 mmHg for individuals under 65.
- This study evaluates the impact of these revised guidelines on identifying uncontrolled hypertension.
Purpose of the Study:
- To assess the change in the proportion of identified uncontrolled hypertension cases following the implementation of new BP guidelines.
- To compare health behaviors, medical history, and current treatments among patients with controlled, newly identified uncontrolled, and existing uncontrolled hypertension.
Main Methods:
- Data collected from 248 hypertensive patients at a family medicine outpatient clinic.
- Patients categorized into controlled (BP ≤ 130/80 mmHg), newly identified uncontrolled (BP 130/80-140/90 mmHg), and existing uncontrolled (BP > 140/90 mmHg) groups.
- Comparison of health behaviors, disease history, and pharmacological treatments across groups.
Main Results:
- The proportion of uncontrolled hypertension increased from 21.7% to 74.2% after applying new guidelines.
- Higher Body Mass Index (BMI) was linked to uncontrolled hypertension (p=0.043).
- Poor medication adherence was significantly associated with uncontrolled hypertension (p<0.013), not the number of medications.
Conclusions:
- Lowering BP targets substantially increases the number of identified hypertensive patients.
- While pharmacological treatment intensification is an option, behavioral factors like weight reduction and improved medication adherence are vital.
- Enhancing medication adherence and promoting weight loss are key mainstream strategies for hypertension management.
Background:
According to the new hypertension treatment guidelines blood pressure (BP) readings need to be kept below or equal to 130/80 mmHg in patients aged less than 65 years old. This study shows the change in proportion of identified cases of uncontrolled blood pressure in light of these changes.
Methods:
The data was collected from 248 hypertensive patients who had visited an outpatient clinic at the Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Thailand. Patients were classified into three groups: The 3 groups were: 1) controlled BP group (BP is 130/80 mmHg or lower); 2) newly identified uncontrolled group (BP between 130/80 mmHg and 140/90 mmHg) and 3) existing uncontrolled group (BP higher than 140/90 mmHg). Health behaviors, past history related to hypertensive disease and current pharmacological treatments were compared.
Results:
Of the total 248 patients, 56% were female and the mean age was 58.8 (sd 5.99) years old. Following application of the new guidelines, the group designated as uncontrolled increased from 21.7 to 74.2%, an additional 52.4% due to new BP targets. Higher BMI was associated with uncontrolled HT (p = 0.043). While the average number of medication taken was similar across the three groups, it was poor medication adherence (p < 0.013) which was associated with the uncontrolled disease.
Conclusions:
Lower BP targets will increase the number of identified hypertensive patients. While intensifying pharmacological treatment may be considered, our study suggests that two behavioral factors should not be overlooked. Weight reduction and enhancement of medication adherence remains an important mainstream treatment strategy.