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May Measure Month 2022 in Italy: A Focus on Fixed-dose Combination, Therapeutic Adherence, and Medical Inertia in a
Rita Del Pinto1, Claudia Agabiti Rosei2, Claudio Borghi3
1Department of Life, Health and Environmental Sciences, Internal Medicine unit, ESH Excellence Center, S. Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.
Insights
Many hypertensive patients have uncontrolled blood pressure (BP) due to poor patient involvement and physician inertia. Prevention campaigns are crucial for improving hypertension management and reducing cardiovascular risk.
Area of Science:
- Cardiology
- Public Health
- Hypertension Management
Background:
- Hypertension is a primary risk factor for cardiovascular diseases (CVD).
- Effective blood pressure (BP) control remains a challenge, with only about half of patients achieving target BP.
- Key barriers include patient non-compliance and physician therapeutic inertia.
Purpose of the Study:
- To assess BP control and management strategies in a large adult population.
- To identify factors contributing to uncontrolled hypertension.
- To highlight the need for improved patient engagement and physician awareness.
Main Methods:
- A nationwide, cross-sectional study conducted during the "May Measure Month" (MMM) campaign (May 1st-July 31st, 2022).
- Involved 1612 adult volunteers (≥ 18 years) with BP measurements and questionnaire data on demographics, clinical features, and antihypertensive medication use.
- Opportunistic screening aimed to raise awareness about high BP health issues.
Main Results:
- Mean BP was 128.5/77.1 mmHg; 55.5% of participants had uncontrolled hypertension.
- Half of participants were sedentary, overweight, or obese.
- Most patients were not on fixed-dose combination therapy and did not monitor BP at home; adherence was high but insufficient for control.
Conclusions:
- The study reveals significant therapeutic inertia and low patient involvement in hypertension management.
- Prevention campaigns are vital for identifying suboptimal management and increasing risk factor awareness.
- Reducing cardiovascular risk necessitates improved patient monitoring and physician intervention.
Introduction:
Hypertension is the main risk factor for cardiovascular diseases (CVD). Notably, only about half of hypertensive patients manage to achieve the recommended blood pressure (BP) control. Main reasons for the persistence of uncontrolled BP during treatment are lack of compliance on the patients' side, and therapeutic inertia on physicians' side.
Methods:
During the global BP screening campaign "May Measure Month" (MMM) (May 1st to July 31st, 2022), a nationwide, cross-sectional, opportunistic study endorsed by the Italian Society of Hypertension was conducted on volunteer adults ≥ 18 years to raise awareness of the health issues surrounding high BP. A questionnaire on demographic/clinical features and questions on the use of fixed-dose single-pills for the treatment of hypertension was administered. BP was measured with standard procedures.
Results:
A total of 1612 participants (mean age 60.0±15.41 years; 44.7% women) were enrolled. Their mean BP was 128.5±18.1/77.1±10.4 mmHg. About half of participants were sedentary, or overweight/obese, or hypertensive. 55.5% individuals with complete BP assessment had uncontrolled hypertension. Most were not on a fixed-dose combination of antihypertensive drugs and did not regularly measure BP at home. Self-reported adherence to BP medications was similar between individuals with controlled and uncontrolled BP (95% vs 95.5%).
Conclusions:
This survey identified a remarkable degree of therapeutic inertia and poor patients' involvement in the therapeutic process and its monitoring in the examined population, underlining the importance of prevention campaigns to identify areas of unsatisfactory management of hypertension, to increase risk factors' awareness in the population with the final purpose of reducing cardiovascular risk.
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