Blood Pressure Control in Outpatients With Hypertension After the Publication of the JSH2000 Guidelines

Though the Japanese Guidelines for the Management of Hypertension (JSH2000) was published in June 2000, it is not clear whether general physicians follow the guidelines or not. Therefore, we examined the blood pressure (BP) in 555 outpatients with hypertension (mean age 70 years old, male 47%) in our hospital, all of them took some type of antihypertensive medicine and maintained a stable BP for the previous 6 months, and determined the rates of control to goal levels.The average BP of all patients was 139/78 mmHg ; 53% were controlled to the systolic goal (<140mmHg), 93% were controlled to the diastolic goal (<90 mmHg), but only 51% were controlled to both goals. The rates of BP controlled to the goal level increased chronologically (10%, 57%, 92% and 97% in under 60, 60-69, 70-79, 80-89 years group, respectively)Taking into consideration disease status, 10% of patients with diabetes mellitus (DM, 9/91), 18% with renal function disturbance (17/95) and 0% with proteinuria of ≥1g/day (0/36) were controlled to the goal level. The systolic blood pressure (SBP) in patients with DM and also with proteinuria of≥1g/day was significantly higher than in patients without DM and proteinuria.The mean sorts of antihypertensive medicine prescribed was 1.5 and Ca antagonists were used in 80% of patients. The patients with proteinuria of ≥1 g/day or renal function disturbance took significantly more medicine than the other patients.Conclusion: The Guidelines (JSH2000) were followed well in hypertensives aged over 70 years without complications, but in those aged under 60 years or in those with complications, goal level was not achieved in enough patients.