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(Hypertension. 2006;48:196.)
© 2006 American Heart Association, Inc.

Editorial Commentaries

From Clinical Trials to Clinical Practice

Why the Gap?

Theodore A. Kotchen

From the Department of Medicine, General Clinical Research Center, Medical College of Wisconsin, Milwaukee.

Correspondence to Theodore A. Kotchen, General Clinical Research Center, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226. E-mail tkotchen@mcw.edu

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

Based on an analysis of National Health and Nutrition Examination Survey data, the prevalence of hypertension in the United States increased from 25.0% in 1988 to 1991 to 28.7% in 1999 to 2000.¹ Despite compelling evidence for the cardiovascular and renal benefits of hypertension control, during that same decade, hypertension control rates increased from 24.6% to only 31.0%. At a time when he was director of the National Heart, Lung, and Blood Institute, Claude Lenfant expressed the concern that the potential benefits of clinical research are lost in the translation into clinical practice.² Others have also pointed out the slow pace of diffusion of new scientific knowledge into health care and have recommended strategies for decreasing the gap between knowledge and clinical practice.³

In this issue of Hypertension, Stafford et al⁴ describe prescription patterns for antihypertensive agents and suggest that prescriptions for specific classes of agents do not reflect incorporation of lessons learned from clinical trial outcomes. Based on data extracted from the National Disease and Therapeutic Index, which is a continuing survey of a national sample of US office-based physicians, between 1990 and 2004, overall, the most frequently prescribed agents were angiotensin-converting enzyme inhibitors (ACEIs) and calcium channel blockers (CCBs); diuretics were the third most frequently prescribed agents. After publication of the results of the Antihypertensive and Lipid-Lowering treatment to prevent Heart Attack Trial (ALLHAT) in 2002, diuretic prescriptions increased by early 2003 and surpassed CCBs. However, by 2004, although the use of diuretics exceeded pre-ALLHAT levels, their . . . [Full Text of this Article]

Related Article:

Long-Term and Short-Term Changes in Antihypertensive Prescribing by Office-Based Physicians in the United States

Randall S. Stafford, Veronica Monti, Curt D. Furberg, and Jun Ma
Hypertension 2006 48: 213-218. [Abstract] [Full Text] [PDF]

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				N. M. Kaplan Clinical Trials for Hypertension: Expectations Fulfilled and Unfulfilled Hypertension, February 1, 2007; 49(2): 257 - 259. [Full Text] [PDF]