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  • Title: Longitudinal study on hypertension control in primary care: the Insubria study.
    Author: Grandi AM, Maresca AM, Sessa A, Stella R, Ponti D, Barlocco E, Banfi F, Venco A.
    Journal: Am J Hypertens; 2006 Feb; 19(2):140-5. PubMed ID: 16448882.
    Abstract:
    BACKGROUND: Hypertension control is still unsatisfactory. The study was aimed to evaluate blood pressure (BP) control rate and the impact of training general practitioners (GPs) about hypertension 1999 World Health Organization/International Society of Hypertension guidelines. METHODS: After a training session on the hypertension guidelines, 588 GPs consecutively enrolled 5524 known hypertensive patients. During the first and follow-up visits (after 3, 6, and 9 months) GPs recorded BP, lifestyle habits, and drug therapy. RESULTS: The BP was controlled in 33.4%, with systolic BP less controlled than diastolic BP. The BP control rate decreased (P < .001) from low to very high cardiovascular risk group and from lean to overweight and obese subjects. At the first visit 97.3% of the patients were already on drug treatment: 40.3% with 1 drug, 38.9% with 2 drugs, 17.2% with 3 drugs and 3.6% with 4 or 5 drugs. The adherence to correct dietary and lifestyle habits was low. The drugs most often used were the angiotensin-converting enzyme inhibitors (3009 patients, 56%). During follow-up body weight and BP decreased; 1 or more drugs were added in 17.8% and the adherence to healthier lifestyle habits significantly increased. At the end of the survey BP control rate was significantly improved (52.7%). CONCLUSIONS: In primary care the hypertension control rate was still unsatisfactory, and our data suggest that it may be due to a not aggressive enough drug treatment and a low adherence to recommended lifestyle and dietary habits. Increasing the knowledge of GPs about guidelines was associated with an improvement of hypertension control rate.
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