| Improving control of hypertension by an integrated approach -- results of the 'Manage it well!' programme. | |
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MedLine Citation:
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PMID: 15643143 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Patient non-compliance is a significant contributor to poor blood pressure control. Although measures to improve compliance are known, they are not in routine use. OBJECTIVE: To apply measures based on current recommendations in an integrated approach in the 'Manage it well!' (MIW) programme, and to determine the improvement in blood pressure control. DESIGN AND SETTING: During the prospective open cohort study, 348 primary and 156 secondary care centres enrolled 6941 hypertensive patients and followed them for 6 months. INTERVENTIONS: An integrated intervention package also applicable to everyday practice was introduced to improve treatment adherence, including education programmes for patients and physicians, tight follow-up with frequent office visits and regular home blood pressure measurements. Treatment was based on either trandolapril or verapamil SR with dose titration, with added-on therapy if necessary. MAIN OUTCOME MEASURE: Rates of control of blood pressure to < 140/90 mmHg. RESULTS: Data were evaluated from 5468 patients, 72% known to have hypertension and 26% newly diagnosed [2% not available (n.a.)]. At baseline only 2.9% of treated patients had their hypertension well controlled (< 140/90 mmHg), but during the programme this increased to 40.9% (P < 0.001). The absolute reduction in office blood pressure was also significant (from 168 +/- 19/97 +/- 11 mmHg to 139 +/- 13/83 +/- 7 mmHg; P < 0.001). No differences in blood pressure control were found between trandolapril and verapamil SR regimens. Office blood pressure was greater than home blood pressure at baseline (168 +/- 19/97 +/- 11 mmHg compared with 151 +/- 17/89 +/- 10 mmHg; P < 0.001), but this difference disappeared at 6 months (139 +/- 13/83 +/- 7 mmHg compared with 140 +/- 13/84 +/- 7 mmHg, respectively). CONCLUSIONS: The integrated, patient-focused approach used in the MIW programme significantly increases the success of treatment in a 'real-world' setting. |
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Authors:
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Laszlo A Szirmai; Csaba Arnold; Csaba Farsang |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of hypertension Volume: 23 ISSN: 0263-6352 ISO Abbreviation: J. Hypertens. Publication Date: 2005 Jan |
Date Detail:
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Created Date: 2005-01-11 Completed Date: 2005-05-31 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 203-11 Citation Subset: IM |
Affiliation:
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National Institute for Sports and Health, Semmelweis University of Medicine, Budapest, Hungary. laszloszirmai@axelero.hu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Antihypertensive Agents / therapeutic use* Blood Pressure Cohort Studies Delivery of Health Care, Integrated / organization & administration* Female Humans Hypertension / drug therapy* Male Middle Aged Patient Compliance Patient-Centered Care / organization & administration* Program Evaluation Prospective Studies |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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