BMJ  2004;328:641 (13 March), doi:10.1136/bmj.328.7440.641-a

Letter

Follow up of hypertension by family practitioners

Select sample and absolute risk of cardiovascular disease

The first 100% of the full text of this article appears below.

EDITOR—Properly conducted trials must inform those who produce guidelines on managing clinical conditions. Birtwhistle et al have contributed to this knowledge base for hypertension in family practice, but I am concerned about the generalisability of their trial.1

Credit: SATURN STILLS/SPL

In choosing patients with "controlled" blood pressure they have selected from a pool of 13% (their figures) of hypertensive Canadians.

Another problem is that hypertension is only one of several risk factors for cardiovascular disease. Frequency of visits is likely to be delineated by the presence of other cardiovascular risk factors and comorbidity and the need for their management. Frequency of review advice should therefore be based on absolute cardiovascular risk rather than the level of a single risk factor.

Mark Nelson, National Health and Medical Research Council fellow

Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Prahran, VIC 3181, Australia mark.nelson@med.monash.edu.au

Competing interests: None declared.

  1. Birtwhistle RV, Godwin MS, Delva MD, Casson RI, Lam M, MacDonald SE, et al. Randomised equivalence trial comparing three month and six month follow up of patients with hypertension by family practitioners. BMJ 2004;328: 204-10. (24 January.)[Abstract/Free Full Text]

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Relevant Article

Randomised equivalence trial comparing three month and six month follow up of patients with hypertension by family practitioners
Richard V Birtwhistle, Marshall S Godwin, M Dianne Delva, R Ian Casson, Miu Lam, Susan E MacDonald, Rachelle Seguin, and Lucia Rühland
BMJ 2004 328: 204. [Abstract] [Full Text] [PDF]

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