To investigate and quantify the extent to which variations in guidelines influence assessment of control of hypertension.
Selected patients had hypertension assessed as controlled or uncontrolled with guidelines from New Zealand, Canada, the United States, Britain, and the World Health Organisation.
Subjects-876 patients with diagnosed hypertension and taking antihypertensive drugs.
Main outcome measures-Proportion of patients with controlled hypertension according to each set of guidelines.
The proportion of patients with controlled hypertension varied from 17.5% to 84.6% with the different guidelines after adjustment for the sampling method.
All five sets of guidelines agreed on the classification for 31% (277) of the patients.
The New Zealand guidelines calculate an absolute risk of a cardiovascular event.
When this was taken as the standard half of the patients with uncontrolled hypertension by the United States criteria would be treated unnecessarily and 31% of those classified as having controlled hypertension by the Canadian guidelines would be denied beneficial treatment.
Conclusions-Hypertension guidelines are inconsistent in their recommendations and need to make clear the absolute benefits and risks of treatment.
Mots-clés Pascal : Hypertension artérielle, Antihypertenseur, Assurance qualité, Evaluation, Pratique professionnelle, Accident cérébrovasculaire, Nouvelle Zélande, Océanie, Traitement, Complication, Homme, Appareil circulatoire pathologie, Chimiothérapie, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Cérébrovasculaire pathologie, Vaisseau sanguin pathologie
Mots-clés Pascal anglais : Hypertension, Antihypertensive agent, Quality assurance, Evaluation, Professional practice, Stroke, New Zealand, Oceania, Treatment, Complication, Human, Cardiovascular disease, Chemotherapy, Nervous system diseases, Central nervous system disease, Cerebral disorder, Cerebrovascular disease, Vascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0334673
Code Inist : 002B12B05B. Création : 10/04/1997.