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Perceived symptoms amongst hypertensive patients in routine clinical practice- a population-based study
K I Kjellgren1, J Ahlner, B Dahlöf
1Department of Medicine and Care, Clinical Pharmacology, Faculty of Health Sciences, Linköping, Sweden. karkj@huk.liu.se
Objectives:
To compare perceived symptoms between patients undergoing antihypertensive therapy and hypertensive patients without drug treatment, and to assess reasons for change of antihypertensive medication in routine clinical practice.
Design:
Population-based multicentre study. Consecutive patients from a randomized sample of centres were given a standardized questionnaire to assess symptoms as well as opinions about their antihypertensive drugs.
Setting:
Fifty-five Swedish primary health care centres and 11 clinics of internal medicine.
Patients:
One thousand and thirteen hypertensive patients on their individually prescribed antihypertensive medication and 13 5 without antihypertensive therapy.
Main Outcome Measures:
Prevalence and perception of symptoms with and without antihypertensive drug therapy, changes of medication and reasons for this.
Results:
Amongst the group of patients on antihypertensive medication, 57% spontaneously reported having had symptoms of high blood pressure before they started their drug therapy. Amongst the patients without antihypertensive drugs, 52% reported having such symptoms. When answering direct questions about different symptoms related to current drug treatment or increased blood pressure, patients with and without medication reported symptoms to a similar extent: 80 and 85%, respectively. A majority of patients (64%) had changed their medication during the course of treatment (range 0-61 years). The mean number of changes was 2.4 times over 12 years. The most common reported cause for changing drug treatment was side-effects (42%).
Conclusions:
The study shows that patients in general perceive symptoms from hypertension. Antihypertensive medication decreases the frequency and intensity of symptoms that might be related to high blood pressure but adds other symptoms linked to the medication. Changes in medication were mostly related to side-effects. The follow-up should pay attention to patients' experience of treatment. A sign of a well-managed hypertension population would be a decrease of symptoms over time.