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A new online blood pressure calculator could help overcome the inadequacies of hypertension treatment in Australia.
A first-of-its-kind new online tool could revolutionise how high blood pressure is treated.
The Blood Pressure Treatment Efficacy Calculator is built on data from nearly 500 randomised clinical trials of more than 100,000 people.
Research published in The Lancet in August shows that the calculator enables doctors to choose the best treatment for each patient based on the degree to which they need to lower their blood pressure.
Professor Anthony Rodgers is the Professor of Global Health at the George Institute for Global Health based in Sydney. He says this new approach overcomes many of the inadequacies of blood pressure treatment in Australia to date.
“Australia just doesn’t do great at blood pressure control. We’ve got a great health system in many ways, but blood pressure control is not one of them,” Professor Rodgers says.
“Our hypertension treatment control rate is not very good compared to other OECD countries. We need to do better in terms of lowering blood pressure.”
“Somewhat surprisingly, this is the first time anyone’s put into an accessible format how well these drugs work in terms of lowering blood pressure.”
“The fact that it just wasn’t available when you’ve got many, many hundreds of trials, a lot of which are not easily accessible, you just can’t make sense of that unless someone pulls it all together in one place.”
Hypertension is the leading risk factor for death in Australia. One in three Australian adults (34%) has raised blood pressure, and among those diagnosed, only 32% have it under control and within a healthy range.
Cardiologist Nelson Wang says the new tool helps overcome this challenge by calculating the average treatment effect seen across hundreds of trials. It also categorises treatments as low, moderate, and high intensity, based on how much they lower blood pressure (BP) — an approach already routinely used in cholesterol lowering treatment.
“With dozens of drugs, multiple doses per drug, and most patients needing two or more drugs, there are literally thousands of possible options, and no easy way to work out how effective they are,” Dr Wang says.
“Blood pressure changes from moment to moment, day to day and by season — these random fluctuations can easily be as big or larger than the changes brought about by treatment.”
The next step is to test this new approach in a clinical trial, where patients will be prescribed treatments based on how much they need to lower their blood pressure, guided by the calculator.
With clear evidence now showing high blood pressure is linked to dementia, as well as heart attack and stroke, Professor Rodgers says it is even more crucial that more accurate approaches to treating hypertension are developed.
“Using the calculator challenges the traditional ‘start low, go slow, measure and judge’ approach to treatment, which comes with the high probability of being misled by BP readings, inertia setting in or the burden on patients being too much,” he said.
The Blood Pressure Treatment Efficacy Calculator was developed over five years to pull all decades of trial data together and put that information in one place in an accessible format.
“There have been some attempts to do that for one class of drug or in one type of patient, but no one’s ever got it all together,” Professor Rodgers says.
“I’m not sure we would’ve done it if we knew just how much work it was. It was an extraordinary labour of love. My colleague, Abdul Salam, in our India office actually led the project and it felt like his children graduating from university, I think [due to the] duration and how much effort went in.”
The Blood Pressure Treatment Efficacy Calculator is open access and available to use now.
Nance Haxton was a journalist at the ABC for nearly 20 years. She’s also worked as an Advocate at the Disability Royal Commission helping people with disabilities tell their stories and as a senior reporter for the National Indigenous Radio Service.
In that time she’s won a range of Australian and international honours, including two Walkley Awards, and three New York Festivals Radio Awards trophies.
Now freelancing as The Wandering Journo, Nance is independently producing podcasts including her personal audio slice of Australia “Streets of Your Town”.
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