HOME HELP SUBSCRIBE ARCHIVE SEARCH TABLE OF CONTENTS FEEDBACK EDITORIAL BOARD ABOUT DOC NEWS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

Services Email this article to a friend Similar articles in this journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Law, B. M. Search for Related Content PubMed Articles by Law, B. M. Social Bookmarking                What's this?

Heart Failure Patients Discharged With Subpar BP Control

Minority patients fare worst

Roughly a third of heart failure patients are discharged from hospitals with blood pressure (BP) readings >140/90 mmHg—levels higher than those recommended by the American Heart Association's (AHA's) Get With the Guidelines Heart Failure quality-improvement program.

Black patients demonstrated the poorest blood pressure control, with just 63% achieving optimal levels, according to analyses of records from 19,206 heart failure patients with diagnosed hypertension. By comparison, 76% of white men and 71% of white women attain the recommended levels at discharge.

In addition, roughly 66% of patients are discharged on three or more hypertension drugs. "That number should be 100% for these patients," asserts lead researcher Daniel T. Lackland, DPH, a professor in the department of biometry and epidemiology at Medical University of South Carolina in Charleston.

The data come from 195 hospitals that pooled patient data on the Internet through the Get With the Guidelines program. On presenting the data at AHA's 2007 Scientific Sessions, held November 4–7 in Orlando, Fla., Lackland noted below-desirable treatment with hypertension drugs in this high-risk population: Only 62% were on diuretics, 65% were on angiotensin-converting enzyme (ACE) inhibitors, and just 19% were on angiotensin II receptor blockers (ARBs).

"These patients are not getting to goal," says Lackland. "Barely 50% have pressures down to 130/80. All of them should be on an ACE or an ARB. We've got to get more aggressive with treatment."

His top recommendation: Greater collaboration between cardiologists and primary care physicians to add drugs or increase dosages until patients achieve optimal blood pressure control.

Footnotes

FYI

More information on the American Heart Association's Get With the Guidelines cardiac care quality improvement program is available at www.americanheart.org/presenter.jhtml?identifier=1165.

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

Services Email this article to a friend Similar articles in this journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Law, B. M. Search for Related Content PubMed Articles by Law, B. M. Social Bookmarking                What's this?