[Blood pressure control in good hands with the general practicioner?]

Area of Science:

• General Practice
• Cardiology
• Public Health

Background:

• Uncontrolled hypertension remains a significant public health concern.
• Therapeutic inertia, the lack of treatment adjustment for uncontrolled hypertension, is prevalent in general practice.
• Factors influencing therapeutic inertia require further investigation.

Purpose of the Study:

• To analyze the prevalence and associated factors of therapeutic inertia in general practice.
• To discuss the appropriateness of therapeutic inertia in the context of shared decision-making and evolving guidelines.
• To examine the role of healthcare professionals, including practice nurses and general practitioners, in hypertension management.

Main Methods:

• Retrospective analysis of a large cohort (n=6400) of patients with uncontrolled hypertension in general practice.
• Statistical analysis to identify factors associated with therapeutic inertia.
• Qualitative discussion on clinical decision-making and guideline implications.

Main Results:

• No therapeutic action was taken during follow-up in 87% of patients with uncontrolled hypertension.
• Older age, lower blood pressure readings, and diabetes were associated with increased therapeutic inertia.
• Specific focus on unjustified inertia in hypertensive diabetic patients was highlighted.

Conclusions:

• While therapeutic inertia is observed, its appropriateness in shared decision-making warrants consideration.
• The role of practice nurses and general practitioner supervision in hypertension management is crucial.
• Despite identified inertia, the overall management of hypertension in general practice is deemed appropriate.