Management of blood pressure in primary care

doi:10.1136/bmj.b940

Published 19 May 2009, doi:10.1136/bmj.b940
Cite this as: BMJ 2009;338:b940

Editorials

Management of blood pressure in primary care

New evidence raises questions about current monitoring and treatmentrecommendations

The first 150 words of the full text of this article appear below.

Two linked studies provide new insights into the monitoring(doi:10.1136/bmj.b1492) and control (doi:10.1136/bmj.b1665)of blood pressure.¹ ² In recent years, emphasis has shiftedaway from treating hypertension as a separate entity towardstreating it in the context of the risk of cardiovascular disease.³This shift has informed randomised controlled trials, such asthe PROGRESS trial, which have looked for (and found) benefitsof treating people at high risk (in this case, those with aprevious stroke or transient ischaemic attack) with blood pressurelowering agents regardless of their blood pressure.⁴ It hasalso influenced guidelines that have recommended lower bloodpressure treatment targets for people at higher risk of cardiovascularevents.⁵ ⁶ Within this new paradigm, we continue to titratethe use of antihypertensive drugs against blood pressure measurements.The two linked studies both provide data to challenge this orthodoxy.

Hypertension is perhaps the most common form of . . . [Full text of this article]

Richard J McManus, clinical senior lecturer¹, Jonathan Mant, professor²

¹ Primary Care Clinical Sciences, University of Birmingham, Birmingham B15 2TT, ² General Practice and Primary Care Research Unit, University of Cambridge, Cambridge CB2 0SR

r.j.mcmanus@bham.ac.uk

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Articles

Home monitoring, a way to go?: Joao Calinas-Correia
BMJ 2009 338: b2623. [Extract] [Full Text]

A new era for blood pressure management: Fiona Godlee
BMJ 2009 338: b2068. [Extract] [Full Text]

Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies: M R Law, J K Morris, and N J Wald
BMJ 2009 338: b1665. [Abstract] [Full Text] [PDF]

Long term monitoring in patients receiving treatment to lower blood pressure: analysis of data from placebo controlled randomised controlled trial: Katherine Keenan, Andrew Hayen, Bruce C Neal, and Les Irwig
BMJ 2009 338: b1492. [Abstract] [Full Text] [PDF]

Blood pressure self monitoring: questions and answers from a national conference: Richard J McManus, Paul Glasziou, Andrew Hayen, Jonathan Mant, Paul Padfield, John Potter, Emma P Bray, and David Mant
BMJ 2008 337: a2732. [Extract] [Full Text]

Targets and self monitoring in hypertension: randomised controlled trial and cost effectiveness analysis: R J McManus, J Mant, A Roalfe, R A Oakes, S Bryan, H M Pattison, and F D R Hobbs
BMJ 2005 331: 493. [Abstract] [Full Text] [PDF]

A strategy to reduce cardiovascular disease by more than 80%: N J Wald and M R Law
BMJ 2003 326: 1419. [Abstract] [Full Text] [PDF]

Guidelines on preventing cardiovascular disease in clinical practice: Rodney Jackson
BMJ 2000 320: 659-661. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

Calinas-Correia, J. (2009). Home monitoring, a way to go?. BMJ 338: b2623-b2623 [Full text]

Rapid Responses:

Read all Rapid Responses

Sphygmomanometers and blood pressure monitoring: we already knew it does not work, now we hear it is not even helpful... but is there the will to change?: Joao Calinas-Correia
bmj.com, 28 May 2009 [Full text]