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Preference for pharmacological management of patients with essential hypertension among senior physicians within Northern Ireland

Journal of Human Hypertension volume 21, pages 969–972 (2007)Cite this article

In Northern Ireland, as elsewhere, hypertension remains a leading cause of morbidity and mortality. Controversy has existed for many years regarding the optimal pharmacological agents for the management of this condition. However, in the UK, both historical and more recent data show that in clinical practice beta-blockers and diuretics are the most commonly prescribed first-line agents for blood pressure (BP) management.1, 2 This pattern of prescribing will have been driven by issues such as cost and availability. In addition, a variety of guidelines from bodies such as British Hypertension Society (BHS), National Institute for Clinical Excellence (NICE) and the European Society of Hypertension will have influenced many doctors. However, these separate guidelines have been seen by some as incongruous, leading to confusion and further controversy.

In 2006, BHS and NICE jointly issued new guidelines for the management of hypertension.3 These advocate the use of either an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (ACE/ARB) as first-line treatment in young (<55 years), non-black patients with essential hypertension, whereas black patients and the elderly should receive calcium channel blockers (CCB) or diuretics. In view of these recent guidelines, we performed a survey of the prescribing practices for the treatment of hypertension among senior physicians within Northern Ireland. In May/June 2006, all 1082 general practitioners (GPs) registered within Northern Ireland, and 159 senior hospital physicians were invited to complete an anonymous postal survey. The doctors were given three theoretical scenarios and asked to choose which drug class would be their initial treatment of choice. Doctors were instructed to assume that the patients had new onset essential hypertension, which was sustained despite lifestyle modifications.

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Authors and Affiliations

  1. Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast, UK

    J C Murphy, K Darragh, A Hamilton, G Manoharan & A A J Adgey

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  1. J C Murphy
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  2. K Darragh
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  3. A Hamilton
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  4. G Manoharan
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  5. A A J Adgey
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Correspondence to J C Murphy.

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Supplementary Information accompanies the paper on the Journal of Human Hypertension website (http://www.nature.com/jhh)

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Murphy, J., Darragh, K., Hamilton, A. et al. Preference for pharmacological management of patients with essential hypertension among senior physicians within Northern Ireland. J Hum Hypertens 21, 969–972 (2007). https://doi.org/10.1038/sj.jhh.1002246

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