Prescribers targeted to reduce hypertension

Increased use of the absolute cardiovascular risk calculator could identify at-risk patients and lead to a reduction in the number of health problems caused by hypertension.

As part of NPS’s latest education program, Treating hypertension, prescribers are encouraged to assess absolute cardiovascular risk in all patients with uncomplicated hypertension and consider holistic treatment options that centre on lifestyle changes.

“Hypertension affects more than 2 million Australians and is the leading cause of death in Australian women, yet lowering blood pressure even slightly can have significant effect,” NPS CEO, Dr Lynn Weekes said.

“Lowering systolic blood pressure by 10 mmHg or diastolic blood pressure by 5 mmHg reduces the relative risk of cardiac events by about 25 per cent and stroke by about 33 per cent. This is irrespective of whether an antihypertensive is prescribed.”

The program encourages health professionals to emphasise that lifestyle changes can substantially improve blood pressure so patients may not need to start an antihypertensive or can delay starting or reduce the number of drugs required to control blood pressure.

“We all know that lifestyle factors contribute significantly to cardiovascular risk, yet patients can underestimate the benefits of small changes,” Dr Weekes said.

Patients newly diagnosed with mild or moderate uncomplicated hypertension and a moderate or low risk of having a cardiovascular event in the next 5 years should be encouraged to make or intensify lifestyle changes.

Blood pressure and absolute cardiovascular risk should be reassessed within 6-12 months to determine whether an antihypertensive should be started. Measurements from outside the clinic including self measurement and ambulatory blood pressure monitoring should be considered before commencing therapy, especially if “white coat effect” is suspected.

Prescribers should also be alert for medication non-compliance and discuss the risks of not taking medicines properly with each person, following recent research by the National Heart Foundation that found almost 50% of patients being treated for hypertension were not following medicine instructions.

Health professionals can participate in the following activities for the Treating hypertension program:

Prescribing Practice Review http://www.nps.org.au/health_professionals/publications/prescribing_practice_review/current/prescribing_practice_review_52
Clinical e-audit

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