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Overcoming Clinical Inertia in the Treatment of Hypertension
Kimika Arakawa1, Rina Imazu2, Yuki Morinaga3
1Department of Clinical Laboratory, NHO Kyushu Medical Center, Japan.
Abstract:
Objective This study aimed to investigate the antihypertensive goal achievement rate for office blood pressure (OBP) and the rate of clinical inertia (inertia) as factors for non-achievement in hypertensive patients in 2020. After documenting these results in the medical records, we observed changes in the achievement rate of the OBP goals in 2020 and 2022. Methods In Study 1, the participants were 517 outpatients (mean age 68.6±13.2 years, 54% women) who visited the Division of Hypertension regularly between March and September 2020. We investigated the achievement rate of OBP goals during that period and confirmed the prevalence of inertia as a possible factor for failure to achieve OBP goals. In Study 2, the participants were 308 who visited the division, and who had at least one condition for which an OBP of <130/80 should be targeted in both 2020 and 2022 (mean age 66.6±12.4 years, 50% of women in 2020). We investigated the trends in the achievement of OBP for the same period in both years. Results The rate of achievement of the OBP goals in 2020 was 48%. Inertia accounted for 14% of the non-achievement factors. The OBP significantly decreased in 2022 in comparison to 2020. The achievement rate of OBP goals showed an increasing trend from 45% in 2020 to 52% in 2022. Conclusion Attending physicians' awareness of unmet antihypertensive goals can help them overcome inertia and improve blood pressure control in patients.
Insights
Physician awareness of unmet blood pressure goals can reduce clinical inertia, improving hypertension control. This study found an increasing trend in achieving office blood pressure goals from 2020 to 2022.
Area of Science:
- Cardiology
- Hypertension Management
- Clinical Practice Research
Background:
- Office blood pressure (OBP) goal achievement remains a challenge in hypertension management.
- Clinical inertia, defined as a failure to intensify therapy when treatment goals are not met, is a significant barrier to effective blood pressure control.
- Understanding the prevalence of OBP goal achievement and clinical inertia is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the rate of office blood pressure (OBP) goal achievement in hypertensive patients in 2020.
- To identify the prevalence of clinical inertia as a factor contributing to OBP goal non-achievement.
- To evaluate changes in OBP goal achievement rates between 2020 and 2022.
Main Methods:
- Study 1 involved 517 outpatients assessing OBP goal achievement and inertia in 2020.
- Study 2 analyzed 308 patients with specific conditions requiring OBP <130/80 mmHg, comparing goal achievement in 2020 and 2022.
- Data were collected from regular visits to a Division of Hypertension.
Main Results:
- In 2020, 48% of patients achieved their OBP goals, with clinical inertia accounting for 14% of non-achievement.
- By 2022, OBP significantly decreased compared to 2020.
- The OBP goal achievement rate increased from 45% in 2020 to 52% in 2022.
Conclusions:
- Physician awareness of unmet antihypertensive goals is a key factor in overcoming clinical inertia.
- Improved awareness can lead to better blood pressure control in hypertensive patients.
- The study indicates a positive trend in OBP goal achievement following increased awareness.
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