[Primary care physicians behaviour in inadequate blood pressure control].
OBJECTIVE
To investigate the behaviour of primary care (PC) physicians on inadequate hypertension control.


METHODS
Cross-sectional and multicentric study.


METHODS
PC clinics in the whole of Spain.


METHODS
Patients > or =18 years old who followed pharmacological antihypertensive treatment since at least 3 months before, selected by a consecutive sampling.


METHODS
Blood pressure measured by family doctors. The therapeutic diagram used before and after the visit was registered, and in those cases in which some kind of modification was adopted, the reasons why.


RESULTS
12,754 hypertensive patients were included. The average age was 63.3+/-10.9 years (57.3% women). A 65% lived in urban areas and the 35% in semi-urban o rural areas. The 63.9% (95% confidence interval, 63.1%-64.8%) showed a bad control of hypertension. The majority of the patients followed a therapeutic regimen of monotherapy (56%) being the ACE inhibitors the most prescribed drug (34.8%), followed by the calcium antagonist (21.3%), and angiotensin II antagonists (17.4%). The percentage of patients with inadequate control of the blood pressure, in which the therapeutic behaviour was modified was 18.3% (95% confidence interval, 17.5%-19.1%) (a change of drug in 47%, association in 34.7% and an increase in the dose in 18.3%). The main reasons for which the therapeutic behaviour was modified was because no drug efficacy (63.7%) and the presence of adverse events (5.5%). The price of the therapy originated 1.2% of the modifications.


CONCLUSIONS
PC physicians behaviour was conservative in uncontrolled hypertension cases. Amongst the doctors who modified their behaviour, by inadequate blood pressure control, the change of drug was the decision most adopted.
Alonso Moreno
F J
FJ
Centro de Salud de Ocaña, Toledo, Spain. falonsom@telefonica.net
Divisón Garrote
J A
JA
Llisterri Caro
J L
JL
Rodríguez Roca
G C
GC
Lou Arnal
S
S
Banegas
J R
JR
Raber Béjar
A
A
de Castellar Sansó
R
R
Gil Guillén
V F
VF
Luque Otero
M
M
D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010821:Physicians, Family; D012424:Rural Population; D013030:Spain; D014505:Urban Population
D000959:Antihypertensive Agents