Abstract 9770: Overcoming Persistent Hypertension in Primary Care: Potential Impact of a Proven Strategy of Intensive Blood Pressure Management Within a National Patient Cohort
BACKGROUND: The Valsartan Intensified Primary carE Reduction of Blood Pressure (VIPER-BP) Study involved > 2000 hypertensive patients with persistently elevated BP managed by > 250 family physicians. It demonstrated that a computer-assisted algorithm to apply intensive pharmacological therapy substantially improved BP levels relative to usual care.
METHODS: From a national cohort study of 733 family physicians and 532,050 patients during 2005-2010, we identified a sub-set of patients being treated for hypertension but with a BP persistently >140/90mmHg who would theoretically benefit from more structured and intensive management. The potential impact of the VIPER-BP intervention, on a sex and BP-specific basis was therefore applied from trial data.
RESULTS: Of 51,721 hypertensive individuals with follow-up visits in the national cohort, 24,710 (48%) remained hypertensive after one year. Of these, 7,235 men (66 ± 13 years, BP 155 ± 13/86 ± 11 mmHg) and 7,844 women (71 ± 13 years, BP 156 ± 14/84 ± 12 mmHg) being treated for hypertension were identified. The “pre and post” histograms show the modeled impact of the VIPER-BP intervention on systolic BP. In men post-intervention BP was projected to have fallen to 139 ± 6/80 ± 9 mmHg and in women to 141 ± 7/77 ± 9mmHg. Overall, this strategy would likely achieve additional BP control (<140/90mmHg) in 3,930 (54%) of men (top) and 4,476 (57%) of women.
CONCLUSIONS: These data confirm the “real-world” potential for structured and intensive BP management to achieve markedly better BP control in primary care in those with persistent hypertension despite initial pharmacological treatment.
- © 2012 by American Heart Association, Inc.