[Treatment decision as a function of cardiovascular risk in isolated systolic hypertension in general medicine. The PREHSI study].
OBJECTIVE
To analyse the decision of treatment made by the GP, based on the characteristics of patients with isolated systolic hypertension (ISH).


METHODS
11,436 patients with SBP > or = 140 and DBP < 90 mmHg were examined by 1,464 GPs who filled out a questionnaire for each patient, which included the patient's BP, risk factors, the presence of target organ damage (TOD), antihypertensive treatment and the physician's decision of treatment during the visit. Before the visit, 4,378 patients were not treated: 57 +/- 13 years: 53% men: BP: 157/81 mmHg; smokers: 30%; diabetes: 8%; dyslipidemia: 17%; BMI > 25 kg/m2: 54%; TOD: 11%. Thus, according to ISH tables, 15% of the patients who were not treated presented a low cardiovascular risk (LR), 69% a medium risk (MR), and 16% a high risk (HR). After the visit, 2,599 patients (59%) started antihypertensive treatment. [table: see text]


CONCLUSIONS
78% of the patients with ISH had at least one other risk factor. Three elements (the grade of ISH, the number of risk factors and the level of CV risks) are significantly taken into account in making the decision of treatment. Decision of treatment was in accordance with ISH recommendation in 91% of patients. Nevertheless, while ISH recommendations are life style measures, only when a LR exists, 39% with a LR were treated. On the other hand, 24% with a HR were not treated.
D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D010821:Physicians, Family; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012307:Risk Factors; D013599:Systole
Décision thérapeutique en fonction du risque cardiovasculaire dans l'HTA systolique isolée en médecine générale. Etude PREHSI.