Compliance with Joint National Committee 7 guidelines in hypertension management in a teaching institution

Am J Med Qual. 2007 Jul-Aug;22(4):251-8. doi: 10.1177/1062860607303293.

Abstract

Aim: To assess compliance with Joint National Committee 7 (JNC 7) guidelines and evaluate target blood pressure (BP) goals among patients with hypertension.

Results: Basic laboratory workup was completed on 75% of patients, and 71% received smoking cessation counseling. Overall BP goal achievement was 45.6%; it was 27.6% and 21.1% among diabetes and chronic kidney disease (CKD) patients, respectively. An average of 2.6 antihypertensive medications were prescribed per patient, with beta-blockers being the most frequently used, followed by thiazide diuretics and angiotensin-converting enzyme inhibitors (ACEIS). ACEIS or angiotensin receptor blockers (ARBs) were not prescribed for 16% of diabetics, 26% of chronic renal failure patients, or 41% of those with history of stroke. Among heart failure patients, 24.1% were not on ACEI or ARBs, and 20.7% were not receiving beta-blockers.

Conclusions: Certain aspects of JNC 7 are not well incorporated into clinical practice, especially among patients with coexisting diabetes and/or CKD.

MeSH terms

  • Alcohol Drinking
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure
  • Comorbidity
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Hospitals, Teaching
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / therapy
  • Male
  • Middle Aged
  • Physical Fitness
  • Practice Guidelines as Topic*
  • Retrospective Studies
  • Smoking Cessation

Substances

  • Antihypertensive Agents