Overcoming therapeutic inertia in patients with hypertension.
Uncontrolled blood pressure (BP) remains a leading contributor to cardiovascular disease and mortality worldwide. Although current practice guidelines recommend treating patients with hypertension to defined BP goals, the approach is not widely implemented, and BP control in clinical practice is much worse than that attained in clinical trials. Recent and ongoing clinical trials are utilizing more aggressive approaches with combination therapy as initial treatment. This article discusses the problem of therapeutic or clinical inertia when attempting to control hypertension and highlights differences in BP control rates between clinical trials and real-world practice. Additionally, the rationale for an ongoing treat-to-goal study using a fixed-dose combination of amlodipine/olmesartan medoxomil in patients with hypertension not controlled on monotherapy is provided.
Nesbitt
Shawna D
SD
Internal Medicine-Hypertension, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-8586, USA. shawna.nesbitt@utsouthwestern.edu
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000209:etiology; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D055118:Medication Adherence; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D017211:Treatment Failure; D016312:Treatment Refusal
D000959:Antihypertensive Agents