Lowered blood pressure targets identify new, uncontrolled hypertensive cases: patient characteristics and implications f
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(2020) 20:869
RESEARCH ARTICLE
Open Access
Lowered blood pressure targets identify new, uncontrolled hypertensive cases: patient characteristics and implications for services in Thailand Naphassanan Charoensab1, Kanokporn Pinyopornpanish1, Phaviga Thangsuk2, Wichuda Jiraporncharoen1 and Chaisiri Angkurawaranon1*
Abstract Background: According to the new hypertension treatment guidelines blood pressure (BP) readings need to be kept below or equal to 130/80 mmHg in patients aged less than 65 years old. This study shows the change in proportion of identified cases of uncontrolled blood pressure in light of these changes. Methods: The data was collected from 248 hypertensive patients who had visited an outpatient clinic at the Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Thailand. Patients were classified into three groups: The 3 groups were: 1) controlled BP group (BP is 130/80 mmHg or lower); 2) newly identified uncontrolled group (BP between 130/80 mmHg and 140/90 mmHg) and 3) existing uncontrolled group (BP higher than 140/90 mmHg). Health behaviors, past history related to hypertensive disease and current pharmacological treatments were compared. Results: Of the total 248 patients, 56% were female and the mean age was 58.8 (sd 5.99) years old. Following application of the new guidelines, the group designated as uncontrolled increased from 21.7 to 74.2%, an additional 52.4% due to new BP targets. Higher BMI was associated with uncontrolled HT (p = 0.043). While the average number of medication taken was similar across the three groups, it was poor medication adherence (p < 0.013) which was associated with the uncontrolled disease. Conclusions: Lower BP targets will increase the number of identified hypertensive patients. While intensifying pharmacological treatment may be considered, our study suggests that two behavioral factors should not be overlooked. Weight reduction and enhancement of medication adherence remains an important mainstream treatment strategy. Keywords: Hypertension, Clinical management, Thailand, Clinical practice guidelines, blood pressure control
* Correspondence: [email protected] 1 Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawarorot Rd, Sriphum, Muang, Chiang Mai 50200, Thailand Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory re
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