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. 2008 Oct;54(10):1418-23.

Prehypertension and hypertension in a primary care practice

Marshall Godwin  1 , Andrea Pike, Allison Kirby, Carolyn Jewer, Laura Murphy
Affiliations

Prehypertension and hypertension in a primary care practice

Marshall Godwin et al. Can Fam Physician. 2008 Oct.

Abstract
in English, French

Objective: To assess the prevalence of prehypertension and the prevalence and treatment of hypertension in a family practice population.

Design: Cross-sectional study.

Setting: An academic family practice unit.

Participants: Practice patients aged 30 to 80 years who had visited the clinic at least once during the 2 years before the study and had at least 1 blood pressure (BP) measurement recorded on their charts during that time period.

Main outcome measures: Most recent BP recorded on the chart; presence or absence of a diagnosis of hypertension recorded on the chart; number and class of prescribed antihypertensive medications.

Results: Of the 1388 patients who met the inclusion criteria, 389 had a diagnosis of hypertension. Of the 999 who did not have a diagnosis of hypertension, 306 (30.6%) met the criteria for prehypertension used in this study (systolic BP of 130 to 139 mm Hg or diastolic BP of 85 to 89 mm Hg). Men and older patients (60 to 80 years of age) were more likely to have prehypertension than other patients were. Of the patients with hypertension, 254 (65%) had achieved a BP level of < 140/90 mm Hg. The majority of hypertensive patients were prescribed 1 or 2 medications. Only 4.5% were using more than 2 different medications.

Conclusion: A large proportion of a family practice's patients need close surveillance of BP because of the prevalence of prehypertension. Despite the improvement in the management of hypertension, only 65% of hypertensive patients had achieved the recommended target BP. Family physicians could be treating their hypertensive patients more aggressively with medications; only 4.4% of patients were using more than 2 different antihypertensive medications, despite 35% not being at target. Hypertension surveillance and treatment to achieve target BP levels continue to be important issues in primary care.

OBJECTIF: Déterminer la prévalence de la pré-hypertension ainsi que la prévalence et le traitement de l’hypertension (HTA) chez la clientèle d’une clinique de médecine familiale.

TYPE D’ÉTUDE: Étude transversale.

CONTEXTE: Une clinique universitaire de médecine familiale.

PARTICIPANTS: Clients de la clinique âgés de 30 à 80 ans ayant visité la clinique au moins une fois au cours des 2 années précédant l’étude et ayant eu au moins une valeur de tension artérielle (TA) inscrite dans leur dossier durant cette période.

PRINCIPAUX PARAMÈTRES ÉTUDIÉS: Dernière TA enregistrée au dossier; présence ou absence d’un diagnostic d’HTA dans le dossier; nombre et classes des antihypertenseurs prescrits.

RÉSULTATS: Des 1388 patients répondant aux critères d’inclusion, 389 avaient un diagnostic d’HTA. Parmi les 999 qui n’avaient pas ce diagnostic, 306 (30,6%) répondaient aux critères de la pré-hypertension utilisés dans cette étude (systolique entre 130 et 139 mm Hg ou diastolique entre 85 et 89 mm Hg). Les hommes et les patients âgés (60 à 80 ans) étaient plus susceptibles que les autres patients d’avoir une pré-hypertension. Parmi les hypertendus, 254 (65%) avaient atteint une TA inférieure à 140/90 mm Hg. La majorité des hypertendus recevaient 1 ou 2 médicaments. Seulement 4,5% prenaient plus de 2 médicaments différents.

CONCLUSION: Une proportion importante de la clientèle d’une clinique de médecine familiale nécessitait une surveillance étroite de la TA à cause de la prévalence de la pré-hypertension. Malgré les progrès du traitement de l’HTA, seulement 65% des hypertendus avaient atteint la TA cible recommandée. Les médecins de famille pourraient utiliser un traitement pharmacologique plus agressif pour leurs patients hypertendus: seulement 4,4% des patients prenaient plus de 2 antihypertenseurs différents, même si 35% n’atteignaient pas la cible. La surveillance et le traitement de l’HTA pour atteindre la TA cible continuent d’être des éléments importants dans les soins primaires.

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