Organisational factors in relation to control of blood pressure: an observational study

Inkster, Melanie; Montgomery, Alan; Donnan, Peter; MacDonald, Tom; Sullivan, Frank; Fahey, Tom
December 2005
British Journal of General Practice;Dec2005, Vol. 55 Issue 521, p931
Academic Journal
Background Studies show that 60-75% of treated patients with hypertension in general practice, still do not reach the recommended blood pressure targets of <150/90 mmHg. Aim To investigate aspects of hypertension management in relation to sociodemographic variables, antihypertensive drug treatment, and organisational factors in primary care. Design of study Observational study over 3 years. Setting Eight general practices in Tayside, UK. Method Participants were 560 randomly selected patients aged 40-79 years receiving treatment for hypertension. The outcome measurement was blood pressure control, expressed in binary form based on the British Hypertension Society audit standard of <150/90 mmHg. Results Of 536 eligible patients, 261 (49%) were defined as having inadequate blood pressure control at the end of the study period. No significant associations were discovered with sex, age, deprivation score and comorbidity. In those patients with inadequate control, 30% had no modifications to their drug treatment during the study period. Blood pressure control at the end of the study period was not associated with number of antihypertensive drugs taken or number of antihypertensive drug modifications. The mean number of clinician contacts was 11 (standard deviation = 8), and mean continuity in primary care was high, although this was not associated with improved blood pressure control. A higher proportion of hypertension-related consultations were associated with increased odds of having inadequate blood pressure control. Conclusion Achieving adequate blood pressure control continues to represent a substantial health problem in a significant proportion of the hypertensive population. Patient, physician and organisational elements play a role in ensuring effective delivery of hypertension care in the community.


Related Articles

  • Hypertension and Erectile Dysfunction. Gidaro, Barbara; Lonati, Chiara; Garagiola, Maria; Periti, Enrica; Morganti, Alberto // High Blood Pressure & Cardiovascular Prevention;Feb2006, Vol. 13 Issue 1, p7 

    Erectile dysfunction (ED) is frequently reported by hypertensive patients. The prevalence increases from 30% at the age of 50 years to 50% or more in patients aged over 70 years, i.e. 2-fold higher than that observed in normotensive subjects of the same age. The conventional view holds that ED...

  • Review: Lower-dose combination antihypertensive therapy is preferable to standard-dose single-drug therapy: COMMENTARY. Linden, Wolfgang // ACP Journal Club;Jan/Feb2004, Vol. 140 Issue 1, p4 

    This article focuses on a study related to value of low dose combination treatment with blood pressure-lowering drugs, published in the 2003 issue of "British Medical Journal." The valuable and well-researched study investigates the effectiveness of the 5 most frequently used drugs for...

  • Blood pressure management. Fallon, Noeleen // World of Irish Nursing & Midwifery;Apr2006, Vol. 14 Issue 4, p35 

    The article focuses on blood pressure management. It defines blood pressure as the pressure exerted within the blood vessel walls as the heart pumps and circulates the blood around the body. It defines hypertension as the level of blood pressure above which intervention has been shown to reduce...

  • Complications of hypertensive emergencies are usually reversible with prompt diagnosis and treatment.  // Drugs & Therapy Perspectives;Apr2004, Vol. 20 Issue 4, p10 

    Although systemic hypertension is a common clinical disorder, hypertensive emergencies occur relatively infrequently in clinical practice. However, when they do occur, it is vital that they are diagnosed rapidly as immediate lowering of blood pressure (BP) is necessary to minimize or reverse any...

  • UPPER EXTREMITY COMPARTMENT SYNDROME SECONDARY TO ACQUIRED FACTOR VIII INHIBITOR. Ilyas, Asif M.; Wisbeck, Jacob M.; Shaffer, Gene W.; Thoder, Joseph J. // Journal of Bone & Joint Surgery, American Volume;Jul2005, Vol. 87-A Issue 7, p1606 

    The article presents a case of a traumatic compartment syndrome of the right forearm in an elderly woman who required fasciotomy. A sixty-seven-year-old black woman with a medical history of hypertension and chronic obstructive pulmonary disease but no history of a bleeding disorder presented...

  • Sitaxentan in Pulmonary Arterial Hypertension: A Viewpoint by Steven Kawut.  // Drugs;2007, Vol. 67 Issue 5, p771 

    The article discusses the author's viewpoint concerning the sitaxentan in pulmonary arterial hypertension. Pulmonary arterial hypertension (PAH) causes significant functional limitations and an increased risk of health. Endothelin (ET)-1 is increased both locally and systematically in patient...

  • Predictors of Antihypertensive Drug Responses: Initial Data from a Placebo-Controlled, Randomized, Cross-Over Study With Four Antihypertensive Drugs (The GENRES Study). Hiltunen, Timo P.; Suonsyrjä, Timo; Hannila-Handelberg, Tuula; Paavonen, Kristian J.; Miettinen, Helena E.; Strandberg, Timo; Tikkanen, Ilkka; Tilvis, Reijo; Pentikäinen, Pertti J.; Virolainen, Juha; Kontula, Kimmo // American Journal of Hypertension;Mar2007, Vol. 20 Issue 3, p311 

    Background: Only a minority of hypertensive individuals is adequately controlled for their hypertension, partially because reliable predictors for efficient antihypertensive drug therapy are lacking. Methods: In a prospective, randomized, double-blind, cross-over, placebo-controlled study (The...

  • Resistant hypertension: a practical clinical approach. Muxfeldt, E S; de Souza, F; Salles, G F // Journal of Human Hypertension;Nov2013, Vol. 27 Issue 11, p657 

    Resistant hypertension (RH) is defined as an uncontrolled office blood pressure (BP) despite the use of at least three antihypertensive drugs. With an increasing prevalence, RH implies in a very high cardiovascular risk and needs a careful clinical approach, aiming to control BP and to reduce...

  • How Do Providers Assess Antihypertensive Medication Adherence in Medical Encounters? Bokhour, Barbara G.; Berlowitz, Dan R.; Long, Judith A.; Kressin, Nancy R. // JGIM: Journal of General Internal Medicine;Jun2006, Vol. 21 Issue 6, p577 

    BACKGROUND: Poor adherence to antihypertensives has been shown to be a significant factor in poor blood pressure (BP) control. Providers' communication with patients about their medication-taking behavior may be central to improving adherence. OBJECTIVE: The goal of this study was to...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics