Interní Med. 2009; 11(6): 282-287 [Med. Pro Praxi 2008; 5(9): 294-298]

How to improve hypertension control in primary care?

MUDr. Jan Peleška CSc

EuroMISE centrum, Ústav informatiky AV ČR a III. interní klinika VFN, Praha

Simplifying the diagnostic and therapeutic procedures within valid recommendations and using the hypertension specialist‘s algorithm

should result in saved time that the GP should devote to improving communication with the patient in order to achieve better

participation of the patient in the treatment of his hypertension. Participation of the patient would mainly involve home blood pressure

measurements and a dialogue with the physician over the daytime blood pressure values and their potential relationship to even mild

adverse reactions to treatment. However, this requires mass use of home blood pressure measurements. By three months at the latest,

each hypertensive patient (even ones with low cardiovascular risk) should receive pharmacotherapy with drugs having the highest degree

of organ protectiveness – angiotensin-converting enzyme (ACE) inhibitors; angiotensin II receptor blockers, AT1 type (AT1B); and

calcium channel blockers (CCBs) that are also best tolerated. Given the economic conditions, high-risk individuals cannot be generally

screened by investigating subclinical organ damage; therefore, treatment must be aimed at achieving more ambitious target blood

pressure values in all hypertensive patients without exception.

Keywords: hypertension control, primary care, recommendations for diagnostic and therapeutic procedures, hypertension specialist‘s algorithm, home blood pressure measurements.

Published: July 1, 2009  Show citation