• F J Alonso Moreno, J A Divisón Garrote, J L Llisterri Caro, G C Rodríguez Roca, S Lou Arnal, J R Banegas, A Raber Béjar, R de Castellar Sansó, V F Gil Guillén, and M Luque Otero.
• Centro de Salud de Ocaña, Toledo, Spain. falonsom@telefonica.net
• Aten Primaria. 2005 Sep 15; 36 (4): 204210204-10.

PurposeTo investigate the behaviour of primary care (PC) physicians on inadequate hypertension control.DesignCross-sectional and multicentric study.SettingPC clinics in the whole of Spain.PatientsPatients > or =18 years old who followed pharmacological antihypertensive treatment since at least 3 months before, selected by a consecutive sampling.MeasurementsBlood pressure measured by family doctors. The therapeutic diagram used before and after the visit was registered, and in those cases in which some kind of modification was adopted, the reasons why.Results12,754 hypertensive patients were included. The average age was 63.3+/-10.9 years (57.3% women). A 65% lived in urban areas and the 35% in semi-urban o rural areas. The 63.9% (95% confidence interval, 63.1%-64.8%) showed a bad control of hypertension. The majority of the patients followed a therapeutic regimen of monotherapy (56%) being the ACE inhibitors the most prescribed drug (34.8%), followed by the calcium antagonist (21.3%), and angiotensin II antagonists (17.4%). The percentage of patients with inadequate control of the blood pressure, in which the therapeutic behaviour was modified was 18.3% (95% confidence interval, 17.5%-19.1%) (a change of drug in 47%, association in 34.7% and an increase in the dose in 18.3%). The main reasons for which the therapeutic behaviour was modified was because no drug efficacy (63.7%) and the presence of adverse events (5.5%). The price of the therapy originated 1.2% of the modifications.ConclusionsPC physicians behaviour was conservative in uncontrolled hypertension cases. Amongst the doctors who modified their behaviour, by inadequate blood pressure control, the change of drug was the decision most adopted.

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