Aim, design and methods of the 'reasons for not intensifying antihypertensive treatment' (RIAT): an international registry in essential hypertension

Failure of physicians to adhere to hypertension guidelinesmay partly account for the failure to achieve bloodpressure (BP) goals in clinical practice. The aim of thistrial is a comprehensive description of the approachof physicians in the management of high BP amongprimary care patients. It will primarily assess what arethe Reasons for not Intensifying an AntihypertensiveTreatment (RIAT), when predefined individual BP goalsare not achieved. Open intervention survey was conductedin 17 countries in Latin America, Eastern Europe,Africa and Asia in family practices, government and privateclinics. The registry is based on a three-step epidemiologicaldesign. Step one shall identify guidelines andrecommendations taken as reference in each country forthe management of hypertension. Step two will assessthe variance between individual targets defined by physiciansin their practice compared to guidelines andrecommendations. Step three is a prospective registrywhere physicians collect patient data at baseline;determine individual target BP values. Several followupvisits are proposed to monitor achievement of thesetargets. Step three of RIAT aims at providing responsesto several key objectives. Recruitment is under wayaiming at enrolling 33 000 patients. To identify, what isthe BP targeted according to the risk factor profile andwhat are the reasons for not modifying an antihypertensivetreatment when BP goals are not reached, and toanalyse the type of antihypertensive drugs prescribedaccording to compelling indications and to assess thepercentage of patients reaching target figures.Journal of Human Hypertension (2006) 20, 31–36. doi:10.1038/sj.jhh.1001937; published online 27 October 2005