TY - JOUR T1 - November Focus JF - British Journal of General Practice JO - Br J Gen Pract SP - 826 LP - 826 VL - 55 IS - 520 AU - David Jewell Y1 - 2005/11/01 UR - http://bjgp.org/content/55/520/826.abstract N2 - ‘ALLHAT's now off for ASCOT’, writes the tireless Richard Lehman (Flora Medica, page 899), and thinks we may now find ourselves shifting patients with high blood pressure from atenolol/bendroflumethiazide combination to ACE inhibitor and calcium channel blocker. But he also predicts that hypertension trials will continue forever, so huge is the current appetite for hypotensive drugs. Compared with the numbers of big trials of drugs, the review on page 875 shows that conclusive evidence on the best ways of managing the care of these patients is more difficult to find. They seem to need the kind of care that we might expect: a vigorous approach to treatment, a properly organised programme of review and reminders to those who fall out of the system. Clinicians who, at least in the past, were happy to accept blood pressures above the treatment target, will find such behaviour labelled as ‘clinical inertia’. But the study on page 838 will make everyone think … ER -