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. 2024 Jun 13.
doi: 10.2169/internalmedicine.3747-24. Online ahead of print.

Overcoming Clinical Inertia in the Treatment of Hypertension

Kimika Arakawa  1 , Rina Imazu  2 , Yuki Morinaga  3 , Mitsuhiro Tominaga  2 , Takuya Tsuchihashi  4
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Free article

Overcoming Clinical Inertia in the Treatment of Hypertension

Kimika Arakawa et al. Intern Med. .
Free article

Abstract

Objective This study aimed to investigate the antihypertensive goal achievement rate for office blood pressure (OBP) and the rate of clinical inertia (inertia) as factors for non-achievement in hypertensive patients in 2020. After documenting these results in the medical records, we observed changes in the achievement rate of the OBP goals in 2020 and 2022. Methods In Study 1, the participants were 517 outpatients (mean age 68.6±13.2 years, 54% women) who visited the Division of Hypertension regularly between March and September 2020. We investigated the achievement rate of OBP goals during that period and confirmed the prevalence of inertia as a possible factor for failure to achieve OBP goals. In Study 2, the participants were 308 who visited the division, and who had at least one condition for which an OBP of <130/80 should be targeted in both 2020 and 2022 (mean age 66.6±12.4 years, 50% of women in 2020). We investigated the trends in the achievement of OBP for the same period in both years. Results The rate of achievement of the OBP goals in 2020 was 48%. Inertia accounted for 14% of the non-achievement factors. The OBP significantly decreased in 2022 in comparison to 2020. The achievement rate of OBP goals showed an increasing trend from 45% in 2020 to 52% in 2022. Conclusion Attending physicians' awareness of unmet antihypertensive goals can help them overcome inertia and improve blood pressure control in patients.

Keywords: Antihypertensive goals; Blood pressure; Clinical inertia; Hypertension.

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