• Stefanie Häckel, Friederike Stein, Gunter Wolf, Günter Stein, and Martin Busch.
• Klinik für Innere Medizin III, Universitätsklinikum Jena.
• Dtsch. Med. Wochenschr. 2018 Jul 1; 113 (13): e108-e116.

Introduction The diagnosis and therapy of arterial hypertension is a continuous challenge in general practice. The aim of this study is to analyze the nature and effectiveness of blood pressure control in patients with known arterial hypertension in a primary care practice using office- (OBPM) and ambulatory (ABPM) blood pressure measurement.Methods 283 patients (90 % of all regularly treated patients having hypertension) were retrospectively examined for the achievement of the target blood pressure values in ABPM and OBPM in the past 1 to 2 years. Target blood pressure levels were in line with current ESH recommendations (office blood pressure < 140/90 mmHg, mean 24-h ABPM < 130/80 mmHg).Results The OBPM of all patients (age: 68 ± 12.7, 48 % women) was 132 ± 11.8/80 ± 4.2 mmHg, the 24-h ABPM was 128 ± 10.7/74 ± 7.9 mmHg. An isolated office hypertension had 11.3 %, a masked hypertension 21.9 %. Only 33.9 % had physiological dipping behavior (49.1 % non-dipper, 13.8 % reverse dipper and 3.2 % extreme dipper). The blood pressure control rate (reaching the target blood pressure) was 67.8 % in the OBPM and 57.2 % in the 24-h ABPM. 23.0 % were treated with monotherapy, 37.5 % with dual combination, 19.8 % with a triple combination and 14.5 % with > 3 antihypertensives. 83.9 % of all had RAS blockers. The OBPM target was achieved in 75.0 % under a triple and 71.7 % under dual combination. The 24-hour ABPM target was mostly achieved in patients requiring only monotherapy (66.2 %) or dual therapy (60.4 %); others < 60 %.Conclusion In the family practice examined, the treatment control of patients with arterial hypertension was mostly guideline-based and better than described in the literature. The parallel and consistent implementation of ABPM in addition to OBPM as well as the high prescription rate of RAS blockers and recommended combination therapies might be the key for this result.© Georg Thieme Verlag KG Stuttgart · New York.

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