It's time to change! (3 comments)

Professor Jean Marco challenges current education methods and proposes to reflect on new ways better adapted to the unmet needs on the management of hypertensive patient.

If I understand correctly, in approximately 40% of hypertensive patients, blood pressure is not adequately controlled in accordance with the pre-defined target.

This occurs despite the availability of an impressive number of different anti-hypertensive molecules or agents.  It is therefore likely to become a major health economics concern in all countries given the tremendous growth in the number of hypertensive patients and the potential consequences of irreversible cardiovascular events resulting from uncontrolled blood pressure.

What causes it?

“Reluctance of patients to adhere to lifelong drug  treatment and lifestyle modifications..”

“Poorly selected antihypertensive agents, inappropriate drug dosages or drugs not prescribed in the correct order, taking into account the patients particularities …”

“The white-coat effect, need for a greater use and more refined interpretation of Ambulatory Blood Pressure Monitoring and Home Blood Pressure controls…”

“Adequate diagnosis of curable secondary hypertension…”

So what?

There’s nothing new in any of this! For years, I have heard or read the same comments followed by this final conclusion: “education is key, … use a team approach… a need for the advice of hypertension specialists...”

What does this mean?

It means that the past and present educational methods are neither appropriate to this current need nor to the future unmet needs! There are gaps between the unmet needs and currently accepted pedagogical methodology.

It’s time to change!

It’s time for us to transform our educational approach and adopt new visionary processes better adapted to the unmet need in adult-learning for adult fellows in training and adult practitioners (and perhaps students?).

There is a wealth of information available to everyone, everywhere in the world on many dedicated websites.

It’s time to change the manner in which we educate by integrating the way current and future new generations are using internet, the basic science of adult-learning, the science of communication, the shared experience of practitioners taking in charge hypertensive patients and the point of view of patient associations. 

Sharing all this expertise and reflecting together would allow us to propose, develop and implement new educative processes which will be more efficient with regard to health economics constraints.

The approaches proposed in the ‘consensus papers’ on the management of resistant hypertensive patients regarding the correction of errors, optimisation of pharmacological treatments, ruling out spurious causes of resistant hypertension, patient selection for new therapies are, in my view, quite debatable.

In the field of interventional medicine we have to make the best use of local resources and implement at a local level more efficient concepts for practitioner education and patient information.

By looking together to the causes, by analysing with intellectual honesty the past, by better understanding the present with a critical whilst positive spirit and searching for added value in adult-learning we could create new and more efficient concepts and therefore build a great future in the new approach for the best management of each locally treated hypertensive patient.  


Let's agree to disagree! Post your comments below! 


Mon, 2013-02-04 15:54

Refering to the paragraph: What causes it? Keep in mind that resistant hypertension (RHTN) and uncontrolled hypertension are two different phenotypes. You are talking about factors leading to a lack of control and these do not require the same management as in patient with RHTN. In case of uncontrolled hypertension a patient centered care is needed which emphasize the need for correct measurement , appropriate drug therapy and therapeutic education. For the RHTN patient it's another story!

Tue, 2013-02-05 04:25

Youre so cool! I dont suppose Ive read something like this just before. So nice to locate somebody with some original thoughts on this subject. realy thank you for starting this up. this web site is some thing that is required on the web, somebody with a little originality. helpful job for bringing something new to the internet!