title: Do primary care physicians follow the current recommendations for hypertensive pharmacotherapy?
abstract: BACKGROUND
  In 2007, the joint recommendations of the European Society of Cardiology and the European Society of Hypertension (ESC/ESH) were announced.
  
  
  OBJECTIVE
  The aim of this survey was to evaluate the implementation rate of the new ESC/ESH recommendations by primary care physicians and to assess the effectiveness of antihypertensive therapy.
  
  
  METHODS
  Data concerning pharmacotherapy, blood pressure (BP) measurements, and compliance with the guidelines were collected in 10,880 hypertensive patients during 3 subsequent follow-up visits.
  
  
  RESULTS
  Combined antihypertensive treatment (angiotensin converting enzyme inhibitors with β-blocker, diuretic, or calcium-channel blocker) was used in 69.2% of the patients at baseline. A combination of β-blocker with diuretic was prescribed in 7.4% of the patients. In 71% of these patients no history of cardiovascular events was reported (myocardial infarction, revascularization, or heart failure). Diuretics were not used in 20.7% of the patients receiving a 3-drug regimen and in 6.7% of those receiving a 4-drug regimen. BP target levels set by individual physicians were frequently lower than those recommended by the guidelines. The percentage of patients who reached the recommended BP target increased during the survey to 25.3%.
  
  
  CONCLUSIONS
  A combination of β-blocker and diuretic is still commonly used in the treatment of hypertension in patients without coronary artery disease and heart failure. Despite the use of combination treatment in about 90% of hypertensive patients and attempts at reaching lower target BP values than those recommended by the guidelines, treatment targets were achieved only in one-fourth of the patients.
authors.affiliation: Department of Pathophysiology, Medical University of Silesia, Katowice, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Żak-Gołąb
authors.forename: Michał
authors.initials: M
authors.lastname: Holecki
authors.forename: Mike
authors.initials: M
authors.lastname: Smertka
authors.forename: Jerzy
authors.initials: J
authors.lastname: Chudek
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001795:Blood Pressure Determination; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005060:Europe; D005062:European Union; D006287:Health Planning Guidelines; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D055118:Medication Adherence; D058007:Physicians, Primary Care / Q000458:organization & administration*; D011044:Poland; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents