Patients with Hypertension at Risk Due to Physician Inertia
Oslo, June 21, 2010 (ots/PRNewswire)
Data announced for the first time at ESH suggest that patients with hypertension are at increased cardiovascular risk due to clinician inertia, because physicians are failing to treat targets set by accepted ESH-ESC (European Society of Hypertension and European Society of Cardiology) guidelines for the management of arterial hypertension and do not act soon enough to reduce blood pressure (BP).[1]
The findings from the Supporting Hypertension Awareness and Research Europe-wide (SHARE) survey, which sought the views of 2629 physicians from primary and secondary care across Europe, were presented at the 20th Annual Meeting of the European Society of Hypertension (ESH), Oslo.
According to SHARE, three quarters of physicians (76%) believe that ESH-ESC guideline BP targets of 140/90 mmHg are 'about right'[2] and 5% say that they are 'not tight enough'.[3]
Despite this, SHARE showed that 29% of physicians, were satisfied with systolic blood pressure being above the ESH-ESC target of <140 mmHg and 15% were satisfied with diastolic blood pressure above target (<90 mmHg). Furthermore, while average blood pressure levels that would cause concern were significantly higher than guideline targets (149/92 mmHg), levels have to rise even further before physicians feel compelled to act (168/100 mmHg).
SHARE reports that 77% of all physicians found it challenging to get patients to ESH-ESC Guidelines, although this represents more office-based (82%) than hospital-based physicians (63%).[4]
In fact, European physicians thought that on average 47% of their patients were not attaining recommended ESH-ESC BP targets, but they estimated that only 34% were 'Challenging Patients', defined by the SHARE investigators as any patient not reaching goal blood pressure with a minimum target of 140/90 mmHg. This suggests either that 13% of patients who are not reaching target are not being treated aggressively enough or that the number of 'Challenging Patients' is underestimated by physicians.[5]
"The risks associated with elevated blood pressure are well documented and any patient with a blood pressure over 140/90 mmHg requires persistent therapy review to achieve target and reduce their cardiovascular risk. By underestimating the number of these 'Challenging Patients', physicians are also failing to recognize the true extent of the economic and health burden associated with this group," warns Prof Josep Redon, Professor of Medicine, Head of Internal Medicine and Coordinator of the Hypertension Unit, Hospital Clinico, University of Valencia, and SHARE Programme co-chair.
In Europe, the levels of blood pressure control among treated hypertensive patients ranges from approximately 30-50%.[6] Hypertension remains the leading cause of mortality and morbidity, and the third largest cause of disability worldwide.[7] 7.6 million people died prematurely in 2001 alone[8] and almost one fifth of all disability adjusted life years (DALYs) in Europe are attributed to the long-term effects of hypertension.[8] In addition to the human cost, uncontrolled hypertension creates a huge economic burden; the annual cardiovascular health bill is in excess of EUR190 billion.[9]
Background to SHARE
The SHARE survey responded to a White Paper published in the Journal of Hypertension,[10] identifying a number of challenges that prohibit hypertensive patients from achieving blood pressure goal. The White Paper also made recommendations around raising awareness of the dangers of uncontrolled hypertension and simplifying treatment.
The SHARE Steering Committee developed a 45 question survey and sought the views of 2629 physicians in primary and secondary care treating patients with hypertension. Its aim is for greater understanding of the local day-to-day challenges that physicians face in getting their patients to blood pressure goal, in order to develop simple and effective solutions, and share best practice and practical solutions via the SHARE Standalone Meeting series.
For the first time, the SHARE Steering Committee have coined the term 'Challenging Patient' for any patient not reaching their goal blood pressure, with a minimum target of 140/90 mmHg, to highlight a significant yet often unrecognized group. The 'Challenging Patient' is at greater cardiovascular risk and a greater resource burden than those whose blood pressure is controlled.[11]
About DAIICHI SANKYO
DAIICHI SANKYO is a global pharmaceutical company that focuses on researching and marketing innovative medications. The company was created in 2005 through the merger of two traditional Japanese enterprises, Daiichi and Sankyo. With net sales of nearly 7.3 billion EUR in fiscal year 2009 (as of March 31st), DAIICHI SANKYO is one of the world's 20 leading pharmaceutical companies. The company's world headquarters is in Tokyo, its European base is located in Munich. DAIICHI SANKYO has affiliates in 12 European countries and has been one of the strongest Japanese pharmaceutical companies located in Europe since it set up European production facilities and marketing offices in 1990. The company's research activities focus on the areas of cardiovascular diseases, hematology, anti-infectives and cancer. Its aim is to develop medications that are "best" in their class or to create new classes of pharmaceutical drugs.
Forward-looking statements
This press release contains forward-looking statements and information about future developments in the sector, and the legal and business conditions of DAIICHI SANKYO EUROPE GmbH. Such forward-looking statements are uncertain and are subject at all times to the risks of change, particularly to the usual risks faced by a global pharmaceutical company, including the impact of the prices for products and raw materials, medication safety, changes in exchange rates, government regulations, employee relations, taxes, political instability and terrorism as well as the results of independent demands and governmental inquiries that affect the affairs of the company. All forward-looking statements contained in this release hold true as of the date of publication. They do not represent any guarantee of future performance. Actual events and developments could differ materially from the forward-looking statements that are explicitly expressed or implied in these statements. DAIICHI SANKYO EUROPE GmbH assumes no responsibility for the updating of such forward-looking statements about future developments of the sector, legal and business conditions and the company.
References
[1] Mancia G, de Backer G, Dominiczak A, et al. 2007 guidelines for the management of arterial hypertension. J Hypertens 2007; 25: 1105-1187
[2] Laurent S, Schmieder R, Koch W, et al. Investigating the critical situation in hypertension management: physician perception and use of the ESH-ESC treatment guidelines (SHARE survey Poster presentation ESH 17-21 June 2010.
[3] Data on file [SHARE charts for all question presentation, question 43 p162
[4] Laurent S, Schmieder R, Koch W, et al. Investigating the critical situation in hypertension management: physician perception and use of the ESH-ESC treatment guidelines (SHARE survey). Poster presentation ESH 17-21 June 2010.
[5] Kreutz R, Ferri C, Koch W, et al. Investigating the critical situation in hypertension management: disparities between the perception and reality of the burden of `Challenging Patients' (SHARE survey). Poster presentation ESH 17-21 June 2010.
[6] Kearney PM, Whelton M, Reynolds K, et al. Worldwide prevalence of hypertension: a systematic review. J Hypertens 2004;22:11-19
[7] Ezzati M, Lopez AD, Rodgers A, et al. Selected major risk factors and global and regional burden of disease. Lancet 2002;360:1347-1360
[8] Lawes CM, Vander Hoorn S, Rodgers A. Global burden of blood-pressure-related disease, 2001.Lancet 2008;371(9623):1513-8.
[9] Allender S, Scarborough P, Peto V, et al. European Heart Network (2008) European cardiovascular disease statistics 2008. Brussels. European Heart Network
[10] Redon J, Brunner HR, Ferri C, et al. Practical solutions to the challenges of uncontrolled hypertension: a white paper. J Hypertens 2008;26(12):S1-S14
[11] Kreutz R, Ferri C, Koch W, et al. Investigating the critical situation in hypertension management: disparities between the perception and reality of the burden of `Challenging Patients' (SHARE survey). Poster presentation ESH 17-21 June 2010.
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