[Is the action taken by Catalonian primary care doctors adequate in view of the insufficient reduction in blood pressure levels in hypertensive patients? DISEHTAC-2001 study].

Objective: To determine the attitude to therapy of primary care staff in view of the lack of reduction in blood pressure. To describe the most commonly used antihypertensives.

Design: Descriptive, longitudinal, retrospective study during the year 2001.

Setting: Primary care, Spain.

Participants: We analysed 990 hypertensive patients from 12 health centres picked from the 31 participants in the DISEHTAC-1996 study.

Methods: Age, sex, weight, and height were analysed, along with blood pressure values throughout the year 2001, therapeutic attitude (increase/replacement/combination) with poor control (more than 2 consecutive visits with blood pressure>139 and/or 89 mm Hg), screening and prevalence of cardiovascular risk factors (CVRF), and drugs used.

Results: There were 58.9% females; mean age: 65.4 (13.01) years, and 43.8% received 2 or more antihypertensives. The most common antihypertensives prescribed were diuretics (47.6%), and angiotensin-converting enzyme (ACE) inhibitors plus diuretics was the most used combination (22.1%). When there was poor control, some change in treatment was made in 76.8% (95% confidence interval [CI], 73.6-80) of cases. The most common was a combination of drugs (49.6%). The expected action was more frequent in those over 65 years and with a grade I of arterial hypertension (systolic blood pressure [SBP] between 140-150 and diastolic blood pressure [DBP] between 90-99 mm Hg (P<.001).

Conclusions: Combined therapy is used in almost half of hypertensive patients, with the most common action being a drug combination.