Strike hard at hypertension
December 2, 2011
THE importance of the role of
pharmacists in supporting patients
with high blood pressure and
ensuring quality use of
medications, has been reinforced
by a new hypertension study
according to Professor Simon
Stewart, Head of Preventative
Health at Baker IDI.
Speaking at a media launch of the
results Stewart said the idea behind
the Valsartan Intensified Primary
Care Reduction of Blood Pressure
Study, nicknamed VIPER, was to
“strike hard and fast against high
blood pressure”.
As such, VIPER trialled an
aggressive GP-led strategy to
optimally manage hypertension
and reduce patients risk of stroke
and heart attack.
“For the first time in Australia,
this study was able to analyse the
efficacy of an aggressive new firstline
management strategy for
patients with high blood pressure,”
Stewart said.
Hypertension is the highest
preventable contributor to disease
and death in the world, with
around one-in-three Australian
adults affected by high blood
pressure at any one time.
Interestingly hypertension is also
the number one most common
reason for Australian GP visits, and
it is the largest contributor to
cardiovascular (CVD) disease in
Australia (with CVD being the
leading cause fo fatality in the
country).
“Investigating new ways to
manage and reduce the burden of
high blood pressure is critical in the
face of rising health costs and an
ageing population,” said Stewart.
“Without more effective blood
pressure management, Australia
faces a perfect storm of
cardiovascular disease risk factors
with a future health crisis of costly
hospital admissions and premature
deaths,” he added.
The randomised clinical VIPER
study recruited 2,300 newly
diagnosed or currently treated
hypertensive Australians being
managed by more than 250 GPs
across the nation, with the aim of
finding out whether a more
intensive approach to hypertension
management would help patients
reach lower blood pressure targets
quicker than with traditional
methods.
Enrolled patients were divided
into groups and received either
standard GP care or the VIPER-BP
strategy.
In the VIPER-BP group patients
were given either one of three
therapies: 160mg or 320mg
valsarten monotherapy; 80mg
valsartan combined with 12.5mg
hydrochlorothiazide; or 80mg
valsarten combined with 5mg
amlodipine besylate, for a period of
26 weeks.
GPs with patients in the VIPER-BP
groups were also given exclusive
access to a new Baker IDI electronic
management tool which was
designed to calculate patients longterm
CVD risk and direct more
intensive disease management.
Patients in the standard GP care
group received whatever
medication their GP thought was
best for hypertension over a 26
week period.
The results of the trial found 36%
of VIPER-BP patients had reached
their blood pressure target at 26
weeks, compared to 28% of usual
care patients.
The study also found that overall
VIPER-BP patients were also 25%
more likely to achieve their ideal
blood pressure goal compared to
their usual care counterparts,
whilst 63% of VIPER patients
achieved the typical blood pressure
target during the six month follow
up period compared to 54% of
usual care patients.
VIPER patients were also found to
achieve a greater reduction in their
risk of future heart attack or stroke
(25%) compared to 16% of usual
care patients.
“The study revealled a more
intensive and structured approach -
including more frequent GP visits
and higher treatment doses - can
control an individual’s blood
pressure more effectively than a
more traditional regime using
fewer adjustments to treatment
and fewer GP visits,” said Professor
Stewart.
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