Clinical trial registration: http://www.clinicaltrials.gov NCT00000542.
Hypertension Control Among Newly Treated Patients Before and After Publication of the Main ALLHAT Results and JNC 7 Guidelines
Article first published online: 16 MAR 2012
© 2012 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 14, Issue 5, pages 277–283, May 2012
How to Cite
Krousel-Wood, M., Muntner, P., Carson, A., Anderson, A. H., Delaune, E., Cushman, W. C., Cutler, J. A., Piller, L. B., Goforth, G. A. and Whelton, P. K. (2012), Hypertension Control Among Newly Treated Patients Before and After Publication of the Main ALLHAT Results and JNC 7 Guidelines. The Journal of Clinical Hypertension, 14: 277–283. doi: 10.1111/j.1751-7176.2012.00609.x
- Issue published online: 25 APR 2012
- Article first published online: 16 MAR 2012
- Manuscript received: October 13, 2011; Revised: January 13, 2012; Accepted: January 22, 2012
J Clin Hypertens (Greenwich). 2012; 14:277–283. ©2012 Wiley Periodicals, Inc.
Medication prescribing practice changed following the publications of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) in 2002 and the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) in 2003. Few data are available on changes in hypertension control rates for patients initiating antihypertensive treatment before and after these publications. The authors compared systolic and diastolic blood pressure (SBP and DBP) levels and hypertension control (SBP <140 mm Hg and DBP <90 mm Hg) rates in patients initiating antihypertensive treatment in a large managed care organization during 2 time periods: July 1, 2001, to June 30, 2002 (n=322); and July 1, 2003, to June 30, 2004 (n=323). The blood pressure reduction associated with antihypertensive medication initiation was similar in 2001–2002 and 2003–2004 (−11.9 and −10.5 mm Hg, respectively, P=.251 for SBP; −6.9 and −5.9 mm Hg, respectively, P=.160 for DBP). The mean SBP and DBP prior to treatment were significantly lower in 2003–2004 vs 2001–2002 (145.4 vs 151.3 mm Hg, P<.001 for SBP; 87.6 vs 90.1 mm Hg, P<.002 for DBP). Hypertension control rates increased from 38.0% to 50.2% (P=.005) from 2001–2002 to 2003–2004. Lower pretreatment SBP and DBP explained hypertension control improvement over time. In this real-world clinic population, antihypertensive treatment was initiated at lower blood pressure levels following publication of ALLHAT and JNC 7, resulting in substantial improvements in hypertension control rates.