World Hypertension League Calls For Urgent Action To Get More Hypertensive Patients To Goal

Main Category: Hypertension
Also Included In: Cardiovascular / Cardiology
Article Date: 12 May 2006 - 0:00 PDT

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This World Hypertension Day, the results of a global survey are being announced, uncovering alarming gaps between current and recommended hypertension management, and important insights into physician awareness of the importance of blood pressure goal achievement.

In response to the Close The Gap survey findings, the World Hypertension League is supporting a call for better awareness of the importance of high blood pressure patients reaching the internationally-recognised goal of 140/90mmHg or lower.

At the moment, around 50-70% of the one billion people with high blood pressure worldwide remain above this goal, leaving them at significant risk of coronary artery disease, heart failure, stroke, vascular and kidney damage 1,2.

Dr Claude Lenfant, President of the World Hypertension League, commented on the survey findings, "Viewed simply, for every 20/10mmHg rise in blood pressure above this level, the risk of death from cardiovascular problems doubles. International guidelines have set a clear goal - every patient with hypertension needs to have their blood pressure reduced to 140mmHg or below".

The Close The Gap survey, conducted with 1,259 primary care physicians across 17 countries, compared physicians' perceptions against the reality of current hypertension management.

Encouragingly, the findings confirmed that most physicians are aware of the recommended blood pressure goal for hypertension patients (140/90mmHg), and that the vast majority (96%) know treating patients to blood pressure goal significantly reduces their risk of cardiovascular disease 4.

However, the survey also showed that over 40% of physicians would be satisfied to reduce patients' blood pressure to an "acceptable level" only, rather than fully to the recommended goal4. Further, surveyed physicians overestimated the proportion of their patients reaching blood pressure goal. Over half believed 70% of their hypertension patients are at their blood pressure goal,4 when epidemiological data show that worldwide only 30-50% of hypertension patients are actually at goal 2.

Examining physician views on treatment options, the survey revealed that physicians believe combination therapy would get more of their patients to goal, with 71% indicating they would give patients combination therapy if not reaching goal on monotherapy4. However, recent studies show that fewer than 20% of uncontrolled monotherapy patients are switched to combination therapy during follow-up visits 5,6.

Additionally, whilst the vast majority of physicians (96%) recognised hypertension is one of the most important cardiovascular conditions, only 54% cited it as one of the most challenging cardiovascular conditions to manage. This suggests that some physicians may currently underestimate what is involved in successfully getting all hypertension patients to goal,4 and may help explain why the number of patients not at goal worldwide is so high.

Respondents identified a need for better patient education, so that patients can take a shared role in achieving blood pressure goal. 83% confirmed that more patients would successfully reach goal if they were more aware of their current blood pressure and their goal.

Dr Lenfant, World Hypertension League, concludes, "The Close The Gap survey has identified key areas where current hypertension management differs from international guideline recommendations. We recognise that hypertension is a very complex and difficult condition to manage, and we welcome the survey in helping to identify areas in which we can work with and support physicians, to get more hypertension patients to goal."

The Close the Gap survey was undertaken as part of the i-Control to Goal campaign. The campaign is a joint initiative to reduce the burden of hypertension, supported by the World Hypertension League in partnership with Bristol-Myers Squibb and sanofi-aventis.

Hypertension

For patients with hypertension that have other conditions (e.g. diabetes) their blood pressure goal may be lower than 140/90mmHg. In healthy people, blood pressure is considered at goal at 120/80mmHg.. Patients should discuss their individual blood pressure goal with their physician. For more information on hypertension, please see the accompanying Hypertension Backgrounder.

About the Close The Gap Survey

1,259 primary care physicians across 17 countries were interviewed via telephone in December 2005. The survey was undertaken by Ipsos Ltd, and supported by the World Hypertension League. The survey was funded by Bristol-Myers Squibb and sanofi-aventis.

About the World Hypertension League

The World Hypertension League is devoted to the advancement of hypertension prevention and control through joint efforts of all national leagues and societies. With more than 15 years of achievements, the WHL seeks to promote the exchange of information among its member organizations and offers internationally applicable methods and programs for hypertension control.

About Bristol-Myers Squibb

Bristol-Myers Squibb is a global pharmaceutical and related health care products company whose mission is to extend and enhance human life.

About sanofi-aventis

Sanofi-aventis Group is the world's third-largest pharmaceutical company, ranking number one in Europe. Backed by a world-class R&D organisation, sanofi-aventis is developing leading positions in seven major therapeutic areas: cardiovascular, thrombosis, oncology, metabolic diseases, central nervous system, internal medicine, and vaccines. The sanofi-aventis Group is listed in Paris (EURONEXT: SAN) and in New York (NYSE: SNY).

References:

1. Kearney PM, Whelton M, Reynolds K, et al. Lancet. 2005; 365(9455):217-23.

2. Wolf-Maier K et al. Hypertension. 2004;43:10-17.

3. Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality. Lancet. 2002;360:1903-1913.

4. Close The Gap Survey. sanofi-aventis and Bristol-Myers Squibb data of file. December 2005.

5. Oliveria S, et al, Arch Intern Med. 2002; 162:413-420.

6. Okonofua, et al, Hypertension. 2006; 47:345-151.

7. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and treatment of High Blood Pressure, Journal of American Medical Association, 2003;289:2560-2571. http://www.nhlbi.nih.gov/guidelines/hypertension/express.pdf

8. European Society of Hypertension-European Society of Cardiology Guidelines for the management of arterial hypertension, Journal of Hypertension, 2003;21:1011-1053

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