CONTROL PROJECT Study: Physicians do not change treatment in patients with uncontrolled hypertension—despite high cardiovascular risk.

A study from Spain showed that although two-thirds of the study patients had uncontrolled hypertension plus high or very high cardiovascular risk, 30% of the primary care physicians thought no change to treatment was needed and 65% suggested improving adherence to non-pharmacological changes such as diet and exercise. Only 56% of the physicians scheduled patients for a new control visit within 3 weeks.

The CONTROL PROJECT was presented at the 21st Annual Scientific Meeting of the American Society of Hypertension and reported in a society press release. The study was a cross-sectional, national, multicenter study in Spain that followed 1,412 patients (55.2% women, mean age 65 years) with treated and uncontrolled hypertension who were seen by 356 primary care physicians.  

Using the 2003 guidelines of the European Society of Hypertension, 34.5% of  the patients were at very high risk and 29.4% were at high risk,. The cardiovascular risk factors were overweight (53.7% of patients), hyperlipidemia (52.2%), diabetes (39.5%) and family history of cardiovascular disease (15.7%). Left ventricular hypertrophy was found in 20.3% and 12.8% had microalbuminuria.

In patients with uncontrolled hypertension (>140/80 mmHg, 130/80 mmHg in diabetics), 41.6% were treated with one antihypertensive drug, and only 45% of physicians recommended a treatment change (increasing dose of single drug in 17.5% of patients; adding an additional drug and/or prescribing a fixed combination compound (35%).

“The results  show that there is a significant lack of concern among primary care physicians about the importance of hypertension treatment in patients at high risk of cardiovascular disease,” said Dr. Antonio Coca of the Hypertension Unit at the Hospital Clínic of the University of Barcelona, Spain.