title: Target blood pressure attainment with antihypertensive therapy in Swiss primary care.
abstract: BACKGROUND
  The control of high blood pressure (BP) remains insufficient in developed as well as in developing countries. We conducted a cross-sectional survey to investigate the management of hypertension and the achievement of target BPs in a large population of hypertensive patients treated by Swiss primary care physicians.
  
  
  METHODS
  Data from 4594 hypertensive patients were collected and assessed for demographic data, mode of treatment and BP achievements for the overall population and for high-risk patients such as diabetics and patients with impaired renal function (CKD patients). Furthermore, we analysed the achieved BP in patients receiving single pill combinations or dual free combinations for the three most commonly prescribed substances.
  
  
  RESULTS
  In this large patient population, 84% of patients were receiving an antihypertensive treatment of which 54% showed BP control (< 140/90 mmHg or < 130/80 mmHg for diabetics and patients with CKD). Considering the higher BP target in the elderly, 60.6% of treated patients were on target. In contrast, 28.8% of treated diabetics and 29.7% of patients with impaired renal function met BP goals. Diuretics and blockers of the renin-angiotensin system were the most commonly prescribed substances. High-risk patients and patients at advanced age (≥ 80 years) received dual free combination more frequently than younger patients. The use of diuretics was particularly high because of the prescription of single pill formulations. Differences in the pattern of drug prescription were found according to the linguistic areas.
  
  
  CONCLUSIONS
  The control of hypertension in the Swiss hypertensive population is relatively high but still insufficient particularly among high cardiovascular risk patients such as diabetics and patients with impaired renal function. A further improvement of BP control could perhaps be achieved with a greater use of single pill combinations particularly in patients with complicated hypertension.
authors.affiliation: Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Groote Schuur Hospital, 7925 Cape Town, South Africa. Hendrik.Schaefer@gmx.ch
authors.forename: Hans Hendrik
authors.initials: HH
authors.lastname: Schäfer
authors.forename: Isabella
authors.initials: I
authors.lastname: Sudano
authors.forename: Gian-Reto
authors.initials: GR
authors.lastname: Theus
authors.forename: Georg
authors.initials: G
authors.lastname: Noll
authors.forename: Michel
authors.initials: M
authors.lastname: Burnier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013557:Switzerland / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents; D004338:Drug Combinations