title: Reasons for switching antihypertensive medication in general practice: a cross-sectional Czech nationwide survey.
abstract: To improve blood pressure (BP) control of their patients, physicians either adjust or switch antihypertensive medication. Currently, there is only limited information available on why physicians decide to switch antihypertensive medications. A questionnaire-based survey was performed between November 2011 and March 2012 in the Czech Republic. General practitioners were asked to fill in questionnaires about their hypertensive patients whose antihypertensive medication they were planning to change. These questionnaires recorded data about patient demographic information, cardiovascular risk factors, BP values, and reasons for switching antihypertensive medication. Two hundred eight-six general practitioners surveyed a total of 4341 hypertensive patients. The mean age of the patients was 59.8 years, 68.9% of patients were overweight or obese. Uncontrolled office systolic and diastolic BP >140/90 mm Hg was present in 89.6% and 81.5% of patients, respectively, despite the fact that 49.4% of patients used a combination of 2 or more antihypertensive drugs. The most common reasons for switching medication were insufficient BP control (73.7%), followed by aiming for a better 24-hour effect (38.4%) and increased cardiovascular risk of the patients (37.7%). The major reason for switching antihypertensive treatment in general practice was insufficient BP control. Switching medication because of adverse drug effects is less frequent than reported a decade ago.
authors.affiliation: From the Department of Internal Medicine I-Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic (JV); Department of Internal Cardiology Medicine, University Hospital Brno, Brno, Czech Republic (PV); Department of Internal Medicine II, Faculty of Medicine in Pilsen, Charles University, Czech Republic (JS); Department of Internal Medicine, Valašské Meziříčí Hospital, Valašské Meziříčí, Czech Republic (PZ); Third Department of Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic (OP); Boehringer Ingelheim Czech Republic (JD); and Cegedim CZ, Czech Republic (JK).
authors.forename: Jan
authors.initials: J
authors.lastname: Václavík
authors.forename: Petra
authors.initials: P
authors.lastname: Vysočanová
authors.forename: Jitka
authors.initials: J
authors.lastname: Seidlerová
authors.forename: Petr
authors.initials: P
authors.lastname: Zajíček
authors.forename: Ondřej
authors.initials: O
authors.lastname: Petrák
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Dlask
authors.forename: Jiří
authors.initials: J
authors.lastname: Krýza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D018153:Czech Republic; D057915:Drug Substitution / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*
chemical_list: D000959:Antihypertensive Agents