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Half those with treatment-resistant hypertension ‘are not on optimal therapy’



Better drug treatment could help tackle almost half the cases of treatment-resistant hypertension in routine practice, claim researchers.

 

The study

US researchers looked at whether patients with uncontrolled hypertension were being prescribed optimal antihypertensive therapy, defined as a diuretic with two or more other blood pressure medications at 50% or greater of the maximum recommended hypertension dose. Some 468,800 hypertensive patients participated in the study, and blood pressure control was defined as <140/<90mmHg.

The results

Nearly a third (31%) of the participants had uncontrolled hypertension and among these patients, 44,684 were prescribed three or more blood pressure medications. Of the patient group being prescribed three or more blood pressure medications, half (49.6%) of patients received optimal therapy, as defined by the researchers. Clinical factors independently associated with optimal blood pressure therapy included black race (OR 1.4), chronic kidney disease (OR 1.31), diabetes mellitus (OR 1.3), and coronary heart disease risk equivalent status (OR 1.29).

What this means for GPs

The researchers concluded that ‘prescribing more optimal pharmacotherapy for uncontrolled hypertensives’ including those with apparent treatment-resistant hypertension ‘could improve hypertension control’.

Circulation 2013, online 9 Aug