From Clinical Trials to Clinical Practice

摘要

Based on an analysis of National Health and Nutrition Examination Survey data, the prevalence of hypertension in the United States increased from 25.0% in 1988 to 1991 to 28.7% in 1999 to 2000.1 Despite compelling evidence for the cardiovascular and renal benefits of hypertension control, during that same decade, hypertension control rates increased from 24.6% to only 31.0%. At a time when he was director of the National Heart, Lung, and Blood Institute, Claude Lenfant expressed the concern that the potential benefits of clinical research are lost in the translation into clinical practice.2 Others have also pointed out the slow pace of diffusion of new scientific knowledge into health care and have recommended strategies for decreasing the gap between knowledge and clinical practice.3In this issue of Hypertension , Stafford et al4 describe prescription patterns for antihypertensive agents and suggest that prescriptions for specific classes of agents do not reflect incorporation of lessons learned from clinical trial outcomes. Based on data extracted from the National Disease and Therapeutic Index, which is a continuing survey of a national sample of US office-based physicians, between 1990 and 2004, overall, the most frequently prescribed agents were angiotensin-converting enzyme …