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US beats Europe for hypertension treatment

By starting treatment for high blood pressure earlier and being more aggressive, physicians in the United States control hypertension significantly better than their counterparts in western Europe report researchers from Temple, the University of Chicago, and Stanford in the Jan. 22, 2007, issue of the Archives of Internal Medicine.

In a study based on clinic visits of more than 21,000 patients with hypertension, the researchers found that 63 percent of U.S. patients had their blood pressure under control defined as less than 140/90 mm Hg compared to 31 percent to 46 percent in Italy, the United Kingdom, Germany, Spain or France.

The study authors caution, however, that better blood pressure control in the United States "should not be too quickly praised." Even in the U.S., they note, nearly half of the hypertension patients did not achieve blood pressure levels that meet current guidelines. "Substantial potential for better hypertension control and future costs savings," they say, "exists in both Europe and the United States."

"We found that U.S. physicians tended to have a lower threshold for beginning treatment and were more willing to increase the dose or add other medications when patients did not respond," said lead author, Richard Wang, M.D., Ph.D., a resident in internal medicine at Temple University Hospital. "This is consistent with more aggressive treatment guidelines in the U.S."

"We also found vast room for improvement, here and abroad," said co-author G. Caleb Alexander, M.D., assistant professor of medicine and a member of the MacLean Center for Clinical Medical Ethics at the University of Chicago. "Overall, less than two-thirds of the patients reached the goals set by expert guidelines."

These deficiencies are important, he added, and suggest that "we need to find ways to overcome clinical inertia, the tendency of physicians and patients to rationalize the causes of elevated blood pressure and to
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Contact: John Easton
john.easton@uchospitals.edu
773-702-6241
University of Chicago Medical Center
22-Jan-2007


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