"With the use of a uniform system for controlling blood pressure aimed at the blood pressure level itself, organized interventions produced high rates of control in all ethnic and age groups in all cities," said study author Ross D. Fletcher, M.D., chief of staff, VA Medical Center, Washington, D.C. "However, while a computerized system helped evaluate the rates of control, it remains the caregiver's responsibility to determine the appropriate interventions for each individual patient."

Optimal Blood Pressure Control and All Cause Mortality in a Clinical Practice Setting (PO-220)A sub-study conducted in the Washington D.C. Veterans Affairs medical center evaluated the impact of optimal BP control on mortality. Investigators found that a user-friendly, searchable, computerized patient record system (CPRS) could help achieve high rates of BP control and be maintained long-term to provide substantial improvement in mortality risk.

In the eight-year study, evaluating 42,346 patients with multiple readings, BP control (<140/90 mm Hg) increased from 44 percent to 79 percent. Investigators divided patients, based on the frequency and success of BP control, into six groups to assess mortality risk:G1: never hypertensive>G2: hypertensive always controlled>G3: BP elevated 1-25% of the time>G4: BP elevated 26-50% of the time>G5: BP elevated 51-75% of the time>G6: BP elevated 76-100% of the time>

At 90 months of follow-up, mortality rates were as follows: G1: 2%, G2:6%, G3:9%, G4:9.2%, G5:10% and G6:11.2% (p<0.001 for the trend). Results were adjusted for age, sex, heart failure, diabetes mellitus, and body mass index (BMI). Comparing the optimal BP control group (G2) to poorly controlled BP control (G6), there was a 47 percent reduction in all cause mortality.

"We conclude that high rates of blood pressure control can be achieved in a usual clinical practice setting and can be maintained long term," said lead researcher Vasilios Papademetriou, M.D., Veterans Affairs Medical Center, Georgetown University. "Optimal blood pressure control provided substantial improvement in mortality risk and even partial blood pressure control provided significant mortality risk reduction."

SOURCE American Society of Hypertension