title: A patient-centric goal in time to blood pressure control from drug therapy initiation.
abstract: A time frame in which newly diagnosed hypertensive patients attain blood pressure (BP) goal would guide patients through uncertainty associated with initiating drug therapy for hypertension control. This study estimates time to BP goal resulting from drug therapy initiation among real-world hypertensive patients and identifies factors associated with variations in time to BP goal. The study uses a historical cohort design. Hypertensive patients who had initiated antihypertensive drug therapy between July 1, 2002, and December 31, 2003, were followed up to 12 months until the end of 2004. Electronic medical records from a medical group were linked with pharmacy claims, as well as with medical claims. Survival analyses were used to compare lengths of time needed to reach BP goals. A total of 223 patients from a real world practice setting had initiated antihypertensive drug therapy. The patients took 3.25 months (95% CI: 2.49-4.82) to reach BP goal. The patient-centric time to BP goal was 7.1 weeks longer than those reported in controlled experimental settings. This finding highlights the gap between results of controlled clinical trials and their application to clinical practice, and informs healthcare practitioners of the importance of setting a patient-centric goal in pharmacological treatment of hypertension.
authors: University of Tennessee Health Science Center, College of Pharmacy, Memphis, TN, USA. shhong@uthsc.edu
authors: Song Hee
authors: SH
authors: Hong
authors: Junling
authors: J
authors: Wang
authors: Sunghee
authors: S
authors: Tak
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D016001:Confidence Intervals; D005260:Female; D006040:Goals; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000959:Antihypertensive Agents
references: Clin Rehabil. 2011 Jun;25(6):487-500
references: 21402652
references: Curr Med Res Opin. 2008 Sep;24(9):2617-26
references: 18687165
references: Clin Rehabil. 2009 Apr;23(4):352-61
references: 19237435
references: Am J Hypertens. 2004 Jun;17(6):495-501
references: 15177521
references: J Clin Psychiatry. 2004 May;65(5):715-20
references: 15163261
references: J Hum Hypertens. 2002 Mar;16(3):147-50
references: 11896501
references: Ann Intern Med. 2002 Apr 2;136(7):493-503
references: 11926784
references: Circulation. 2007 May 29;115(21):2761-88
references: 17502569
references: Blood Press Suppl. 1997;2:76-80
references: 9495632
references: Clin Rehabil. 2011 Dec;25(12):1128-39
references: 21795404
references: JAMA. 2003 Jul 9;290(2):199-206
references: 12851274
references: J Hypertens Suppl. 1999 Jun;17(2):S7-13
references: 10465061
references: N Engl J Med. 1997 Apr 17;336(16):1117-24
references: 9099655
references: Am J Hypertens. 2007 Jul;20(7):807-15
references: 17586417
references: J Am Diet Assoc. 2001 May;101(5):562-6
references: 11374350
references: JAMA. 2003 May 21;289(19):2560-72
references: 12748199
references: JAMA. 1977 Jan 17;237(3):255-61
references: 576159