Optimising management of hypertension in primary care: the valsartan intensified primary care reduction of blood pressure (viper-bp) study
International Journal of Cardiology, 11/23/2011

Stewart S et al. – In contrast to typical primary care management of hypertension, valstartan intensified primary care reduction of blood pressure (VIPER–BP) combines more intensive and aggressive therapies with structured management to more rapidly attain and sustain individualised BP targets in hypertensive patients.

• To identify the features of General Practitioner (GP) management of hypertension in Australia, authors analyse the response to a case scenario–based survey of 500 GPs.
• Authors subsequently recruited a national cohort of GP Investigators to enrol up to 2500 patients into the VIPER–BP Study.

• GP responses clearly demonstrated that, compared to the VIPER–BP intervention, a heterogeneous approach to the primary care management of hypertension persists in Australia.
• By November 2010, 2157 hypertensive patients from 272 actively recruiting GP Investigators were enrolled into the study.
• Of these, 1965 (91%) patients were entered into a standardised “run–in” phase of 28days of valsartan 80mg/day.
• Subsequently, 1285 patients were randomised to usual care (n=435) or the VIPER–BP intervention (n=850).
• There was a predominance of males (62%), whilst 55% had pre–existing diabetes or cardiovascular disease and 63% had been previously treated for hypertension.
• Mean systolic and diastolic BP on randomisation for men and women, respectively, was 148±15/88±11 and 148±18/87±10mm Hg.