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Hypertension. 2006;47:319-320
Published online before print January 23, 2006, doi: 10.1161/01.HYP.0000200692.23410.c9
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(Hypertension. 2006;47:319.)
© 2006 American Heart Association, Inc.

Editorial Commentaries

Hypertension and the Treating Physician

Understanding and Reducing Therapeutic Inertia

Lawrence J. Fine; Jeffrey A. Cutler

From the Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.

Correspondence to Lawrence J. Fine, 6701 Rockledge Dr, Rm 8138, MSC-7936, Bethesda, MD 20892. Email finel@nhlbi.nih.gov


An extract of the first 250 words of the full text is provided, because this article has no abstract.
 

The tide of hypertension is rising across the globe, including the United States.1 Among the 65 million Americans with hypertension, inadequately treated patients contribute substantially to the overall magnitude of the problem. Based on data from the National Health and Nutrition Examination Survey, 68% of the total remains above the therapeutic guideline for blood pressure (BP) goals. Those not at goal divide into 3 groups: those unaware of their high BP (&31%), those who are aware but are not being treated (&11%), and those who are being treated but remain above the goal of 140/90 mm Hg (&27% of all hypertensive persons, or 47% of those treated with medication).2

In this innovative article using data from a diverse set of medical practices in the Southeastern part of the United States, Dr Okonofua and colleagues provide some insights into this latter group’s inadequate treatment. The focus of their research is therapeutic inertia (TI), defined as "the provider’s failure to increase therapy when the treatment goals are unmet."3 Although their sample was not based on a regional or national probability sample, their findings from the Southeast may have wide applicability, given that the level of BP control in their study was 45% at the end of the 2003 study period, not too different than the national rate of control of 53% among persons treated for hypertension reported for 1999 to 2000. The principal manifestation of TI (or clinical inertia, a more common term) documented in this study is failure to increase the . . . [Full Text of this Article]


Related Article:

Therapeutic Inertia Is an Impediment to Achieving the Healthy People 2010 Blood Pressure Control Goals
Eni C. Okonofua, Kit N. Simpson, Ammar Jesri, Shakaib U. Rehman, Valerie L. Durkalski, and Brent M. Egan
Hypertension 2006 47: 345-351. [Abstract] [Full Text] [PDF]



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