Overcoming therapeutic inertia in patients with hypertension

Postgraduate Medicine
Shawna D Nesbitt

Abstract

Uncontrolled blood pressure (BP) remains a leading contributor to cardiovascular disease and mortality worldwide. Although current practice guidelines recommend treating patients with hypertension to defined BP goals, the approach is not widely implemented, and BP control in clinical practice is much worse than that attained in clinical trials. Recent and ongoing clinical trials are utilizing more aggressive approaches with combination therapy as initial treatment. This article discusses the problem of therapeutic or clinical inertia when attempting to control hypertension and highlights differences in BP control rates between clinical trials and real-world practice. Additionally, the rationale for an ongoing treat-to-goal study using a fixed-dose combination of amlodipine/olmesartan medoxomil in patients with hypertension not controlled on monotherapy is provided.

References

Mar 8, 2003·Archives of Internal Medicine·Janice G DouglasUNKNOWN Hypertension in African Americans Working Group of the International Society on Hypertension in Blacks
Apr 24, 2003·JAMA : the Journal of the American Medical Association·Henry R BlackUNKNOWN CONVINCE Research Group
Dec 6, 2003·Hypertension·Aram V ChobanianUNKNOWN National High Blood Pressure Education Program Coordinating Committee
Dec 23, 2003·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Brent M Egan, Jan N Basile
Jan 18, 2006·The Journal of Clinical Hypertension·Elizabeth O Ofili
Jun 21, 2006·Hypertension·Theodore A Kotchen
Dec 16, 2006·The Journal of Clinical Hypertension·William C Cushman, Jan Basile
Jul 7, 2007·Blood Pressure·Kenneth JamersonUNKNOWN ACCOMPLISH Investigators
Nov 29, 2007·Journal of General Internal Medicine·Adam J RoseNancy R Kressin
Dec 6, 2007·The Journal of Clinical Hypertension·Michael A Weber
May 6, 2008·Lancet·Carlene M M LawesUNKNOWN International Society of Hypertension
May 16, 2008·BMJ : British Medical Journal·UNKNOWN Blood Pressure Lowering Treatment Trialists' CollaborationS MacMahon

❮ Previous
Next ❯

Citations

Feb 11, 2014·Journal of Hypertension·Carlos EscobarUNKNOWN PRESCAP 2010 investigators
Aug 16, 2013·Therapeutic Advances in Cardiovascular Disease·Benjamin J EpsteinNancy L Borja-Hart
Mar 18, 2020·Scientific Reports·Domingo Orozco-BeltranConcepcion Carratala-Munuera

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.