Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Physician attitudes to blood pressure control: findings from the Supporting Hypertension Awareness and Research Europe-wide survey Josep Redon a , Serap Erdine b , Michael Bo ¨ hm c , Claudio Ferri d , Rainer Kolloch e , Reinhold Kreutz f , Ste ´ phane Laurent g , Alexandre Persu h , Roland E. Schmieder i , on behalf of the SHARE Steering Committee Objectives The Supporting Hypertension Awareness and Research Europe-wide (SHARE) physician survey aimed to qualify the key challenges that physicians face when trying to get patients to blood pressure (BP) goal. Methods The SHARE survey was open to physicians involved in the treatment of patients with hypertension, was anonymous, and was designed to take 15 min to complete. The survey included 45 questions covering physicians’ demographic information, views on the BP targets recommended by the European Society of Hypertension– European Society of Cardiology guidelines, opinions on acceptable levels of BP control, and perceptions about the challenges associated with getting patients to BP goal. Results The survey was conducted between May and December 2009, and 2629 European physicians responded. The mean (W SD) levels of SBP/DBP that physicians were satisfied with, concerned about, or would cause them to take immediate action were 131.6 W 9.5 /81.9 W 5.6, 148.9 W 11.3 / 91.6 W 5.8, and 168.2 W 17.1 / 100.1 W 7.8 mmHg, respectively. Overall, 95.0 and 90.1% of the physicians, respectively, felt that patients SBP/DBP needed to be higher than the guideline recommended goal levels before taking immediate action. Conclusion Clinical hesitation in relation to reducing elevated BP to goal levels is putting patients at increased cardiovascular risk and contributing to the substantial health and economic burden associated with uncontrolled BP. A number of strategies are discussed that have been shown to be effective in countering this problem. J Hypertens 29:1633–1640 Q 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Journal of Hypertension 2011, 29:1633–1640 Keywords: antihypertensive agents, hypertension, patient compliance, physician–patient relations, treatment goals Abbreviations: AMI, acute myocardial infarction; BP, blood pressure; CV, cardiovascular; HCP, healthcare professional; HF, heart failure; PFP, pay for performance; SHARE, Supporting Hypertension Awareness and Research Europe-wide a Hypertension Clinic, Internal Medicine, Hospital Clinico, INCLIVA, University of Valencia, and CIBERObn Carlos III Health Institute, Valencia, Spain, b Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University, Cerrahpasa, Istanbul, Turkey, c Klinik fu ¨ r Innere Medizin III, Universita ¨ tsklinikum des Saarlandes, Homburg, Saarland, Germany, d Universita ` dell’Aquila, Facolta ` di Medicina e Chirurgia, Dipartimento di Medicina Interna e Sanita ` Pubblica, L’Aquila, Italy, e Evangelisches Krankenhaus Bielefeld, Klinik fur Innere Medizin, Kardiologie, Nephrologie und Pneumologie, Bielefeld, f Charite ´ , Universtita ¨ tsmedizin Berlin Institute of Clinical Pharmacology and Toxicology, Berlin, Germany, g Department of Pharmacology and INSERM U970, Hospital European Georges Pompidou, Paris Descartes University, Paris, France, h Division of Cardiology, Cliniques Universitaires Saint Luc (UCL), Brussels, Belgium and i Medizinische Klinik, University Erlangen-Nuernberg, Erlangen, Germany Correspondence to Josep Redon, Hypertension Clinic, Internal Medicine, Hospital Clinico, INCLIVA, University of Valencia, Valencia, Spain Tel: +34 9638 626 47; fax: +34 9638 626 47; e-mail: josep.redon@uv.es Received 21 December 2010 Revised 31 March 2011 Accepted 13 May 2011 Introduction It is well established that hypertension is a major risk factor for the development of cardiovascular disease, including cerebrovascular, renal and peripheral disease, and that throughout middle and old age there is a con- tinuous relationship between increasing blood pressure (BP) and the risk of cardiovascular events starting at SBP and DBP values in the normotensive range [1,2]. It is widely recognized that lowering BP in hypertensive patients can significantly reduce the risk of cardiovascular morbidity and mortality, with more intense BP lowering providing greater risk reductions [3–8]. In order to maximise reduction of long-term cardiovas- cular risk, the 2007 European Society of Hypertension– European Society of Cardiology (ESH–ESC) practice guidelines for the management of arterial hypertension recommended that BP should be lowered to at least below 140/90 mmHg in all hypertensive patients and to at least below 130/80 mmHg in patients with diabetes [9]. However, at present, BP control rates among patients treated for hypertension across Europe remain sub- optimal with less than 50% of patients achieving BP goal [10,11]. Barriers in clinical practice, that are not specifi- cally hypertension related, but which can prevent patients from achieving BP goals, can be split into three main categories: physician related; patient related; and healthcare system related [12,13]. Physician-related barriers that prevent patients from achieving BP goal include clinical inertia, poor communication style, and Original article 1633 0263-6352 ß 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins DOI:10.1097/HJH.0b013e328348c934