Blood Pressure Levels in Treated Hypertensive Patients in General Practice in Norway

Westheim, Arne; Klemetsrud, Trine; Tretli, Steinar; Stokke, Hans Petter; Olsen, Harald

doi:10.1080/080370501750183372

Cited by 37 publications

(26 citation statements)

References 9 publications

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“…in numerous studies that investigated the control of BP as measured in the office (17)(18)(19)(20)(21)(22)(23)(24). These results are also consistent with a population survey in Japan (35), reflecting the effects of aging on vascular compliance: well-controlled DBP in the elderly could be the result not of antihypertensive treatment but of a natural, age-dependent change.…”

Section: Discussionsupporting

confidence: 74%

“…A large proportion of hypertensive patients on antihypertensive medication have inadequate office BP control (17)(18)(19)(20)(21)(22)(23)(24), even though safe and effective therapies for hypertension are readily available, and the importance of obtaining optimal BP control through the use of these therapies is increasingly recognized. Efforts to understand poor BP control have usually focused on patient adherence to therapy and patient characteristics associated with nonadherence.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Control of Blood Pressure as Measured at Home and Office, and Comparison with Physicians' Assessment of Control among Treated Hypertensive Patients in Japan: First Report of the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) Study

et al. 2004

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Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Control of Blood Pressure as Measured at Home and Office, and Comparison with Physicians' Assessment of Control among Treated Hypertensive Patients in Japan: First Report of the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) Study

et al. 2004

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“…Prevalence and severity of hypertension increase markedly with advancing age in women, such that a higher percentage of women than men have high BP after 65 years. [1][2][3][4][5] Furthermore, BP control is more difficult to achieve in older women. Data from the Framingham Heart Study showed gender differences in BP control rates and in the pattern of antihypertensive medications prescribed.…”

Section: Introductionmentioning

confidence: 99%

Hypertension in women

Pimenta

2011

Hypertens Res

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Hypertension is an important modifiable risk factor for cardiovascular (CV) morbidity and mortality, and a highly prevalent condition in both men and women. However, the prevalence of hypertension is predicted to increase more among women than men. Combined oral contraceptives (COCs) can induce hypertension in a small group of women and, increase CV risk especially among those with hypertension. Both COC-related increased CV risk and blood pressure (BP) returns to pretreatment levels by 3 months of its discontinuation. The effects of menopause and hormone replacement therapy (HRT) on BP are controversial, and COCs and HRT containing the new generation progestin drospirenone are preferred in women with established hypertension. Despite the high incidence of cancer in women, CV disease remains the major cause of death in women and comparable benefit of antihypertensive treatment have been demonstrated in both women and men. Hypertension Research (2012) 35, 148-152; doi:10.1038/hr.2011; published online 1 December 2011Keywords: blood pressure; treatment; women INTRODUCTIONHypertension is an important modifiable risk factor for cardiovascular (CV) morbidity and mortality, and a highly prevalent condition in both men and women. Blood pressure (BP) is generally higher in men than in women regardless of age. Mean systolic BP in the overall population increases progressively throughout adult life in both men and women. During early adulthood mean systolic BP is higher in men than women, but the subsequent rate of rise in BP is steeper for women than men. Prevalence and severity of hypertension increase markedly with advancing age in women, such that a higher percentage of women than men have high BP after 65 years. 1-5 Furthermore, BP control is more difficult to achieve in older women. Data from the Framingham Heart Study showed gender differences in BP control rates and in the pattern of antihypertensive medications prescribed. 3 An age-related decrease in BP control rates were more pronounced in women than in men. Among the oldest participants with hypertension, only 23% of women (vs. 38% of men) were controlled to BP o140/90 mm Hg. Treatment with thiazide diuretics was also more frequent among women than men (38 vs. 23%). It is unknown whether the age-related decline in BP control among women is related to true treatment resistance because of biological factors or to inappropriate drug choices in the clinical setting.This article discusses practical aspects related to hypertension in women and some topics are discussed in detail in separate articles in this special review edition.

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“…As in many previous surveys in the population, [9][10][11][12][13][14][15][16][17][18][19][20] in primary care [21][22][23][24] and in specalist care, 25 a substantial number of treated patients did not reach target blood pressure, leading to an overall poor blood pressure control. In the current study, blood pressure control was somewhat better in treated patients with isolated systolic hypertension than in those with diastolic hypertension, but the lower prevalence of treatment resulted in a worse overall blood pressure control in isolated systolic hypertension.…”

Section: Treatment Of Isolated Systolic Hypertension Rh Fagard and M mentioning

confidence: 99%

“…Since a substantial number of patients were under pharmacological treatment and as pretreatment blood pressure was not considered in these cross-sectional surveys, investigators could not satisfactorily distinguish between patients with isolated systolic hypertension and patients with diastolic hypertension. Also studies on treatment and blood pressure control in general practice [21][22][23][24] and specialist care 25 did not separately report on isolated systolic hypertension and diastolic hypertension. When only untreated and inadequately treated patients were considered in the cross-sectional NHANES III survey, 19 isolated systolic hypertension was the most frequent subtype of uncontrolled hypertension in the elderly.…”

mentioning

confidence: 99%

Treatment and blood pressure control in isolated systolic hypertension vs diastolic hypertension in primary care

Enden

2003

J Hum Hypertens

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Cross-sectional surveys on prevalence, treatment and control of hypertension could not satisfactorily distinguish between diastolic hypertension and isolated systolic hypertension because the definition of hypertension included patients under pharmacological treatment. We assessed the situation in the two types of hypertension in general practice in Belgium, based on current blood pressure (BP) measurements and on BP prior to the initiation of drug therapy. Participating physicians enrolled the first 15 at least 55-year-old men visiting the surgery, measured their BP and recorded data on medical history including pretreatment BP, drug utilization, cardiovascular risk factors and target organ damage. Diastolic hypertension was defined as diastolic BPX90 mmHg, irrespective of systolic BP, and isolated systolic hypertension as systolic BPX140 mmHg and diastolic BPo90 mmHg. Among 3761 evaluable patients, 74% were hypertensive. Among the 1533 hypertensive patients in whom blood pressure was known prior to treatment (n ¼ 965) or who were untreated at the study visit (n ¼ 568), 1164 had diastolic hypertension and 369 isolated systolic hypertension. The prevalence of antihypertensive treatment was, respectively, 75 and 25% (Po0.001) in these two types of hypertension. The odds of being treated were independently determined by type of hypertension, severity of hypertension and level of risk (Po0.001). BP was controlled in 25% of all patients with diastolic hypertension and in 13% of all patients with isolated systolic hypertension (Po0.001). About half of the treated patients with systolic hypertension were on a diuretic and/or a calcium-channel blocker. In conclusion, isolated systolic hypertension is less frequently treated than diastolic hypertension, overall BP control is poor and actual drug therapy diverges from recommendations based on placebo-controlled intervention trials.

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Blood Pressure Levels in Treated Hypertensive Patients in General Practice in Norway

Cited by 37 publications

References 9 publications

Control of Blood Pressure as Measured at Home and Office, and Comparison with Physicians' Assessment of Control among Treated Hypertensive Patients in Japan: First Report of the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) Study

Control of Blood Pressure as Measured at Home and Office, and Comparison with Physicians' Assessment of Control among Treated Hypertensive Patients in Japan: First Report of the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) Study

Hypertension in women

Treatment and blood pressure control in isolated systolic hypertension vs diastolic hypertension in primary care

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