Improvement Required In Hypertension Management
Seventy-five percent of the estimated 50 million adults with hypertension in the United States are at increased risk for vascular disorders, according to an overview of its management.
Researchers reviewing the present situation relative to the disorder acknowledge it is the most prevalent health problem among adults in primary care. Its recognition and treatment, however, is suboptimal.
Despite evidence from several large-scale, randomized, controlled studies, which suggest that treatment of hypertension reduces both morbidity and mortality, its present management is characterised by under-diagnosis, misdiagnosis, under- and over-treatment and misused medication, say the authors.
Careful attention is necessary regarding the patients’ age, gender, race, diet, exercise, tobacco use, co-morbid conditions, the choice of antihypertensives drug, for therapy to be effective. In addition, complying with treatment and the achievement of blood pressure control are essential.
Other issues meriting attention include accuracy of the initial diagnosis, self-monitoring of blood pressure, and the advisability of either attempting to reduce the dosage or even attempting possible withdrawal from antihypertensive therapy once the blood pressure has been controlled for 12 months, or more.
The author considers that physicians’ knowledge and use of the report from the Sixth Joint National Committee on Prevention, Detection and Treatment of High Blood Pressure is deficient.
Their review encompasses a number of responses to the current crisis in caring for patients. This includes computer-aided management; medical chart audit, academic detailing and use of prepared algorithms by a nurse care manager, in consultation with a physician.
