Title Australian blood pressure control rates “atrocious”: call to action Media name/outlet MJA Insight Plus Country/Territory Australia Date 6/12/21 Description AUSTRALIA’S blood pressure (BP) control rates are “atrocious” by international standards, according to one of several experts who are calling for Australia to set bold targets to tackle hypertension.
Professor Markus Schlaich, Dobney Chair in Clinical Research at the University of Western Australia Medical School, was commenting in the wake of an MJA Perspective he has co-written with Professor Garry Jennings of the National Heart Foundation of Australia and Professor Aletta Schutte and Associate Professor Ruth Webster of the George Institute for Global Health in Sydney...
However, the call has received a lukewarm response from the Royal Australian College of General Practitioners (RACGP).
“BP management is really important because it’s one of the risk factors that contributes to a lot of disease, but choosing how to monitor BP and who to treat should be done on the basis of the risk of those diseases or existence of those diseases, not just a set of measures that comes off a BP cuff,” RACGP spokesperson, Professor Mark Morgan, Professor of General Practice at Bond University told InSight+.
Professor Morgan questioned whether the figures quoted by Schutte and colleagues truly reflected undertreatment of hypertension in Australia.
“The authors of the paper are really concerned about whether a patient’s recorded BP was above the treatment target of 140 mmHg/90 mmHg,” he said. “But if we are treating patients to target, we should expect to see a large number of patients whose BP is hovering around that target, sometimes a little bit over it.”
Professor Morgan raised concern that focusing merely on hypertension could lead to overtreatment.
“Antihypertensive medication reduces the risk of death and morbidity considerably for people with high absolute cardiovascular risk, but we must not ignore the risks of overtreating those who have low overall risk,” he said.
“For instance, BP targets might need to be adjusted for elderly and frail patients to account for the increase in medication side effects, such as dizziness and the risk of falls.”
Professor Morgan agreed there was much work to be done to improve the nation’s cardiovascular health – “but not hypertension as a separate issue”.
He said gains could come through establishing social prescribing systems that supported people to live healthier lifestyles. He also welcomed the new Medicare Benefits Schedule item for diagnosis of hypertension through ambulatory BP monitoring, which became available in November.
Persons Mark Morgan