Related Experiment Videos
How much can blood pressure be lowered?
Insights
Treatment for high blood pressure often falls short of goals, with many patients failing to reach target diastolic blood pressure levels. Standardizing treatment analysis is crucial for improving hypertension management outcomes.
Area of Science:
- Cardiology
- Public Health
- Clinical Trials
Background:
- Therapeutic goals for diastolic blood pressure in hypertensive patients are frequently not achieved in real-world settings.
- Published data indicates significant percentages of treated patients do not reach target blood pressure levels.
Purpose of the Study:
- To evaluate the effectiveness of antihypertensive treatments across different healthcare systems.
- To highlight the discrepancies between proposed therapeutic goals and actual patient outcomes.
Main Methods:
- Analysis of data from controlled therapeutic trials (Australian trial, Hypertension Detection and Follow-up Program).
- Review of treatment outcomes in British hospital clinics and a specific clinic in Paris (Artemis system).
- Assessment of diastolic blood pressure levels in treated hypertensive patients.
Main Results:
- 24.5% to 29.9% of actively treated patients in trials exceeded 90 mm Hg diastolic blood pressure.
- Up to 69% of treated patients in British clinics had diastolic blood pressure >90 mm Hg after 6-12 months.
- In one study, 21.1% of patients still had diastolic blood pressure >95 mm Hg after 2 years of treatment.
- Rates of treated patients not attaining goal levels in the general population range from 42.9% to 71%.
Conclusions:
- Current antihypertensive treatments show suboptimal results in achieving target diastolic blood pressure across various healthcare systems.
- There is an urgent need to standardize methods for collecting and analyzing antihypertensive treatment results.
- Therapeutic failures may stem from physician strategy, patient factors, disease characteristics, and drug limitations.
Abstract:
Whatever the therapeutic goal proposed for diastolic blood pressure in hypertensive patients, the actual results of treatment in various health care delivery systems throughout the world are not as good as generally assumed. In the two recent controlled therapeutic trials, 24.5% (Australian trial) and 29.9% (Hypertension Detection and Follow-up Program) of actively treated patients had diastolic blood pressure levels above 90 mm Hg. In three British hospital clinics, diastolic blood pressure was greater than 90 mm Hg in 69% of the treated patients after 6 months to 1 year of treatment. In our own clinic, the blood pressure of 947 hypertensive patients registered in the Artemis system (Paris) between 1976 to 1980 decreased after 2 years on medical treatment from 177/108 to 142/87 mm Hg. However 21.1% of the patients studied still had a diastolic blood pressure above 95 mm Hg. In the general population, the percentage of treated patients not attaining goal levels varies from 42.9% to 71%. Not only is it important to agree upon goals, but it is urgent to standardize methods for collecting and analyzing the results of antihypertensive treatments in various health care delivery systems, since high rates of therapeutic failures might be related to the physician's strategy, the patient's characteristics, the disease's particularities, and the limited efficacy and side-effects of presently available drugs.