The REassessment of Antihypertensive Chronic Therapy (REACT) study. An Italian observational study on hypertension managment in patients with established therapy

Aim: The principal aim of the REACT study (REassessment of Antihypertensive Chronic Therapy) was to achieve a comprehensive assessment of hypertension management in Italy from both the physician and patient points of view. Blood pressure control, global risk factors, target organ damage stratification, use of diagnostic examinations, prescribing practices and physician/patient satisfaction with the planned therapeutic regimen, as well as an assessment of patient quality of life were evaluated. A total of 1482 hypertensive patients and their physicians participated in this study. Experimental Design: REACT was a multicentre, non-intervention, cross-sectional, observational study of the management of hypertension in Italy. Hypertensive patients were selected from specialised clinics from the following sub-specialties: cardiology, internal medicine, geriatrics, diabetology and nephrology. Patient Population: Between 10 and 20 patients were enrolled in each of the 131 participating centres. Eligible patients had to have been diagnosed with primary hypertension for at least 1 year and been on stable antihypertensive therapy for at least 1 year. Enrolment began in March 2003 and concluded in March 2004. Conclusions: Hypertension management in Italy remains inadequate. This conclusion is based on poor control of blood pressure and cardiovascular risk factors, persistence of target organ damage, inadequate use of diagnostic tests and examinations, and a deficient therapeutic approach. Since this study was performed in patients with antihypertensive treatment established for at least 1 year and followed by expert specialist physicians, these findings are worrisome and indicate the need for more stringent and effective recommendations for the clinical management of hypertensive patients.