Navigation Links
Changing the way doctors treat high blood pressure
Date:11/5/2007

LONDON, ON (Nov 5, 2007) - Scientists at Robarts Research Institute have developed a simplified and more effective method of treating high blood pressure.

The study, led by clinical pharmacologist Dr. Ross Feldman, showed that more patients lowered their blood pressure - and to a greater extent - when their family doctors used a simplified treatment protocol rather than having to choose from the large number of drugs available to treat high blood pressure. While the study's focus was hypertension, its results could prompt a paradigm shift in the way physicians treat a host of chronic diseases.

Dr. Feldman presented his study results at the American Heart Association conference in Orlando on Sunday, November 4.


Please see the full release from the American Heart Association:

When Treating High Blood Pressure, Simplicity is Best

ORLANDO, Nov 4, 2007 A simplified, step-care protocol for treating high blood pressure was more effective than guidelines-based practice in helping people reduce their blood pressure, according to late-breaking clinical trial results presented at the American Heart Associations Scientific Sessions 2007.

The Simplified Treatment Intervention to Control Hypertension (STITCH) trial was a study of 2,104 patients with high blood pressure (hypertension) at 45 family practices in southwestern Ontario, Canada. In order to increase the number of people with hypertension who reduce their blood pressure to goal levels, researchers wanted to see if there was a simpler way to direct treatment for hypertension than by following national guidelines for optimal management of blood pressure.

The complexity of existing guidelines for the management of hypertension could be a barrier to effective therapy, said Ross D Feldman, M.D., R.W. Gunton Professor of Therapeutics, University of Western Ontario, London, Canada. To examine this question, we conducted a cluster randomization trial. Family practices were randomly assigned to implement a simplified step-care algorithm (STITCH-care) or Guidelines-based care for the management of hypertension.

The STITCH algorithm consisted of 4 steps: 1) initiate therapy with ACE-inhibitor/diuretic or Angiotensin receptor blocker/diuretic combination 2) up-titrate combination therapy to the highest does 3) add a calcium channel blocker and up-titrate 4) add one of the non-first line antihypertensive agents. In the Guidelines-care arm physicians were educated on the use of existing national guidelines of the Canadian Hypertension Education Program, which list 12 options for initial therapy depending on the type of hypertension and co-existing medical conditions (very similar to the range of options outlined in the US JNC guidelines).

The proportion of patients who reduced blood pressure to the target level was higher in the STITCH-care group (65 percent) compared with the Guidelines-care group (53 percent). Average systolic blood-pressure (the top number in a blood pressure measurement) was reduced by 23 mmHg in the STITCH-care arm, compared to a lesser reduction of 18 mmHg in the Guidelines-care arm. In addition, diastolic blood pressure (the bottom number) was reduced by 10 mmHg in the STITCH-care patients vs. 8 mmHg in the Guidelines-care group.

Assignment to the STITCH-care arm increased the chance of reaching the optimal blood pressure target by over 20 percent, Feldman said. We believe that use of a simplified algorithm for the treatment of hypertension is implementable, accepted by family physicians and results in improved blood pressure control rates. This return to step-care may be an important way forward for the treatment of hypertension and may be a paradigm for the management of a range of chronic diseases.


'/>"/>

Contact: Anthea Rowe
arowe@robarts.ca
519-663-3524
University of Western Ontario
Source:Eurekalert

Related medicine news :

1. UK junior doctors gaining less experience of common procedures
2. Doctors Often Miss High Blood Pressure in Kids
3. One-fourth of HIV patients believe their doctors stigmatize them
4. Annual flu shot cuts need for doctors visits, hospitalization among children
5. Teens need to see their doctors more often
6. Doctors and medical ethicist discuss whether doctors should participate in capital punishment
7. Doctors and Medical Ethicist Discuss Whether Doctors Should Participate in Capital Punishment
8. South Texas Doctors Report More Severe Cases of Community Staph Super Bug Hospitalizing Children
9. Maimonides Expands Circulation of Physicians Practice Journal to Staten Island Doctors
10. Doctors Debate Drugs vs. Surgery for Angina
11. UCI Medical Affiliates Inc. Opens a New Doctors Care Center in Anderson
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... A revolution is ... emergency ambulance transport experience for the millions of people who require these medical ... the taxi industry through the use of technology. Now, SmartEMS has put forth ...
(Date:6/26/2016)... (PRWEB) , ... June 26, 2016 , ... PawPaws ... a new product that was developed to enhance the health of felines. The formula ... , The two main herbs in the PawPaws Cat Kidney Support Supplement ...
(Date:6/25/2016)... ... June 25, 2016 , ... The temporary closing of Bruton Memorial Library on June 21 due ... up a new, often overlooked aspect of head lice: the parasite’s ability to live away ... a common occurrence, but a necessary one in the event that lice have simply gotten ...
(Date:6/25/2016)... ... ... On Friday, June 10, Van Mitchell, Secretary of the Maryland Department of ... recognition of their exemplary accomplishments in worksite health promotion. , The Wellness at Work ... Symposium at the BWI Marriott in Linthicum Heights. iHire was one of 42 businesses ...
(Date:6/24/2016)... ... , ... Marcy was in a crisis. Her son James, eight, was out of control. Prone ... physically. , “When something upset him, he couldn’t control his emotions,” remembers Marcy. “If ... at my other children and say he was going to kill them. If we ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016  MedSource announced ... as its e-clinical software solution of choice.  This ... best possible value to their clients by offering ... The preferred relationship establishes nowEDC as the EDC ... for MedSource,s full-service clients.  "nowEDC has long been ...
(Date:6/23/2016)... 2016 Any dentist who has made an implant ... process. Many of them do not even offer this as ... high laboratory costs involved. And those who ARE able to ... a high cost that the majority of today,s patients would ... Parsa Zadeh , founder of Dental Evolutions Inc. and inventor ...
(Date:6/23/2016)... Ill. , June 23, 2016  In a startling report ... are failing their residents by lacking a comprehensive, proven plan to ... a definitive ranking of how states are tackling the worst ... to only four states – Kentucky , ... Vermont . Of the 28 failing states, three ...
Breaking Medicine Technology: