Factors Associated With Early Blood Pressure Control In Newly Diagnosed Hypertensive Patients

Objective: In January 2013, the French society of HTA (SFHTA) issued a recommendation to enhance the management of patients with high blood pressure (BP) in France. This recommendation put great emphasis of the ’diagnosis announcement procedure ’ and the first 6 months of therapeutic management of a hypertensive patient. This initial period of management, crucial for the patient's adherence, has not been the subject of much study. The primary endpoint was to evaluate and estimate the impact of initial management and the patient's perception of the disease on BP control in newly treated hypertensive patients. Design and method: This observational retrospective study was carried out in France in 2016 within a representative sample of general practitioners, in a usual follow-up. Each doctor had to include 4 consecutively treated hypertensive patients for more than 3 months and less than one year (3 uncontrolled + 1 controlled). The data was carried over by each physician from the consultation data, and by the patients in a self-questionnaire. Results: 214 doctors included 846 patients. Data from 643 patients could be analysed. The patients were 58 ± 10 years old and 61.5% were male. 23.8% had BMI > 30 kg/m2. Significantly different data between controlled patients (mean BP: 129 ± 6/77 ± 6 mmHg) and uncontrolled (mean BP: 158 ± 11/93 ± 8 mmHg) were summarized in the following table. Analysis of the concordance between the physician's declarative data on patient information and the patient's perception of this information shows that early-controlled patients receive more comprehensive information than other patients and have a better adherence or are more in agreement with the information issued by doctors than uncontrolled patients.Conclusions: This study shows that factors usually associated with late BP control can also have an impact at the early therapeutic stages. The results underline how the deliverance of the initial diagnosis may impact patient's perception and BP control. A standardisation of the deliverance of this information through a dedicated consultation, as advocated by the French recommendations seems legitimate.