Simple method for treating high blood pressure developedNovember 14th, 2007 - 8:33 am ICT by admin
Led by clinical pharmacologist Dr. Ross Feldman, the study showed that more patients lowered their BP - and to a greater extent - when their family doctors used the simplified treatment rather than having to choose from the large number of drugs available to treat high blood pressure.
The study was presented at the American Heart Association conference in Orlando on Sunday, November 4.
The Simplified Treatment Intervention to Control Hypertension (STITCH) trial was a study of 2,104 patients with high blood pressure (hypertension) at 45 family practices in southwestern Ontario, Canada.
In order to increase the number of people with hypertension who reduce their blood pressure to “goal” levels, researchers wanted to see if there was a simpler way to direct treatment for hypertension than by following national guidelines for optimal management of blood pressure.
“The complexity of existing guidelines for the management of hypertension could be a barrier to effective therapy,” said Ross D Feldman, M.D., R.W. Gunton Professor of Therapeutics, University of Western Ontario, London, Canada.
“To examine this question, we conducted a cluster randomization trial. Family practices were randomly assigned to implement a simplified step-care algorithm (STITCH-care) or Guidelines-based care for the management of hypertension,” Feldman added.
The STITCH algorithm consisted of 4 steps: 1) initiate therapy with ACE-inhibitor/diuretic or Angiotensin receptor blocker/diuretic combination 2) up-titrate combination therapy to the highest does 3) add a calcium channel blocker and up-titrate 4) add one of the non-first line antihypertensive agents.
In the Guidelines-care arm physicians were educated on the use of existing national guidelines of the Canadian Hypertension Education Program, which list 12 options for initial therapy depending on the type of hypertension and co-existing medical conditions (very similar to the range of options outlined in the US JNC guidelines).
It was found that the proportion of patients who reduced blood pressure to the target level was higher in the STITCH-care group (65 percent) compared with the Guidelines-care group (53 percent).
Average systolic blood-pressure (the top number in a blood pressure measurement) was reduced by 23 mmHg in the STITCH-care arm, compared to a lesser reduction of 18 mmHg in the Guidelines-care arm. In addition, diastolic blood pressure (the bottom number) was reduced by 10 mmHg in the STITCH-care patients vs. 8 mmHg in the Guidelines-care group.
“Assignment to the STITCH-care arm increased the chance of reaching the optimal blood pressure target by over 20 percent,” Feldman said.
“We believe that use of a simplified algorithm for the treatment of hypertension is implementable, accepted by family physicians and results in improved blood pressure control rates. This return to ’step-care’ may be an important way forward for the treatment of hypertension and may be a paradigm for the management of a range of chronic diseases,” Feldman added. (ANI)
- Common hypertension drugs can raise certain patients' BP - Aug 20, 2010
- Singing lowers patient's BP prior to surgery - Mar 31, 2011
- High-blood-pressure treatment 'too aggressive' for people over 80 - Dec 23, 2009
- Why hypertensive people's BP increases during exercise - Apr 05, 2011
- Garlic could help treat hypertension - Nov 17, 2010
- Short blast of radio waves to kidneys 'can help control high BP' - Nov 18, 2010
- Less medication is better for high blood pressure: Study - Mar 20, 2009
- Low doses of blood pressure medications effective against hypertension - Mar 20, 2009
- Beta-blockers-anti-hypertensive drugs combo lowers high BP - Jan 20, 2010
- Benefit of exercise in patients with hypertension insufficiently investigated - Oct 27, 2010
- Limiting salt key to warding off serious threats to diabetics' health - Dec 08, 2010
- 'Water pills' just as effective as costly BP drugs: Study - Aug 13, 2010
- Frequent doctor visits can help diabetics control BP more quickly - May 25, 2010
- Left, right arm differences in BP lowers survival chances - Mar 21, 2012
- Study confirms 'water pill' outperforms other high blood pressure drugs - May 14, 2009
Tags: ace inhibitor, algorithm, american heart association, angiotensin receptor blocker, canada, canadian hypertension education program, clinical pharmacologist, combination, control hypertension, diuretic, family practices, goal levels, high blood pressure, management of hypertension, national guidelines, ross feldman, study showed that, titrate, were randomly assigned