Simple, shared guidelines raise the quality of antihypertensive treatment in routine care

Fausto Avanzini, Alessandra Corsetti, Teresa Maglione, Claudio Alli, Fabio Colombo, Valter Torri, Irene Floriani, Gianni Tognoni

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: To assess the impact of simple, collectively produced, evidence-based guidelines on optimizing the choice of anti-hypertensive drugs in routine care. Methods and Results: Forty-eight physicians agreed to produce and test these guidelines for 1 year in their daily practice on a random sample of 1049 treated hypertensive patients (intervention group). A control group of 42 general practitioners recruited and followed up for 1 year a parallel nonintervention cohort of 722 treated hypertensive patients. After 1 year of follow-up, the patients in the nonintervention group had no changes in any of the predefined end points. In the intervention group, the use of diuretics and β-blockers-drugs with documented preventive efficacy-increased, respectively, from 48.3% to 57.6% and from 22.0% to 29.7%; and the proportion of hypertensive patients receiving indicated drugs (with no contraindications) rose from 66.1% to 73.0%. The prescription of poorly tolerated drugs decreased from 12.4% to 7.2%, and noncompliance with the antihypertensive therapy decreased from 5.2% to 3.8%. In the intervention group, both systolic and diastolic blood pressure control improved (systolic pressure

Original languageEnglish
Pages (from-to)726-732
Number of pages7
JournalAmerican Heart Journal
Volume144
Issue number4
DOIs
Publication statusPublished - Oct 1 2002

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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