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Treatment Intensification Does Not Always Lead to Better Quality of Care in Patients with Hypertension
- Barbara J. Turner, MD, MSEd;
- David St. Michel, MPH; and
- Simon Tang, MPH
- From the University of Pennsylvania, Philadelphia, PA 19107; Drexel University, Philadelphia, PA 19103; and Pfizer, New York, NY 10017.
IN RESPONSE:
Dr. Valderas raises concerns about evaluating the quality of care for uncontrolled hypertension at only 1 visit, as we do in our article. We concur that a physician should not intensify treatment when a patient has been poorly adherent. Recommendations about lifestyle changes may also be reasonable depending on the patient's blood pressure. Because of these short-term factors, Kerr and colleagues (1) suggested that quality of care should be evaluated only after 2 consecutive visits with an elevated blood pressure. In light of this recommendation, we examined hypertension management in …
