Physicians know how to manage hypertension but antihypertensive therapy should be started earlier

One in two adults in Finland has hypertension but less than 30% of those treated will reach the recommended blood pressure level. In the past, the selected antihypertensive medication in essential hypertension hasn’t been optimal and the emphasis has been on beta-blockers.

We collected and analyzed data from the patient administration system of Turku city health centre. Persons who had been diagnosed with hypertension and who had renewed at least one prescription in 2017 were included in the study. In addition, we used a questionnaire to collect data on prescription practices of physicians regarding antihypertensive drugs.

In our study, one in three people had been diagnosed with hypertension. An ACE inhibitor/ARB was the most commonly used antihypertensive drug in monotherapy and in combination therapy. One in five of those without coronary artery disease or atrial fibrillation were using a beta-blocker as monotherapy. The questionnaire data showed that 5% of the physicians would initiate antihypertensive medication at the recommended level of 135/85 mmHg and 38% at the level of 140/90 mmHg.

Hypertensive patients mainly use primary public health care services. Physicians are familiar with the Finnish evidence-based medicine guidelines for managing hypertension. The prognosis of hypertensive patients could be improved by initiating antihypertensive therapy earlier.