New data suggest that patients with hypertension are at increased cardiovascular risk due to “clinician inertia”, because physicians are failing to treat targets set by accepted guidelines and do not act soon enough to reduce blood pressure.

The findings from the SHARE survey, based on the views of 2,629 physicians from primary and secondary care across Europe, were unveiled at this week’s European Society of Hypertension meeting in Oslo. The analysis notes that 76% of doctors polled believe that guideline BP targets of 140/90 mmHg are “about right” and 5% say that they are ”not tight enough”.

Despite this, SHARE showed that 29% of physicians, were satisfied with systolic BP being above the accepted target of 140 mmHg and 15% were happy with diastolic BP above 90 mmHg. Also while average blood pressure levels that would cause concern were significantly higher than guideline targets (149/92 mmHg), “levels have to rise even further before physicians feel compelled to act “(168/100 mmHg), the report notes.

SHARE states that European physicians thought that on average 47% of their patients were not attaining recommended targets, but they estimated that only 34% were ‘challenging patients’, ie any patient not reaching the minimum BP target of 140/90 mmHg. This suggests either that 13% of patients who are not reaching target are not being treated aggressively enough or that the number of ‘challenging patients' is underestimated by doctors.

By underestimating the number, Josep Redon of the University of Valencia, and SHARE co-chair said that doctors “are also failing to recognise the true extent of the economic and health burden associated with this group”. He told PharmaTimes World News that “we know what we need to do but we’re not doing it”.

Hypertension remains the leading cause of mortality and morbidity, and the third largest cause of disability worldwide. The SHARE study notes that almost one-fifth of all ‘disability adjusted life years’ in Europe are attributed to the long-term effects of hypertension and “in addition to the human cost, uncontrolled hypertension creates a huge economic burden; the annual cardiovascular health bill is in excess of 190 billion euros”.