General practitioners' management of hypertension in elderly patients.
OBJECTIVE
To assess general practitioners' attitudes to the diagnosis and management of hypertension in elderly patients.


METHODS
Postal questionnaire to all general practitioners in Leicestershire.


RESULTS
360 of 451 general practitioners (80%) responded. 81% (292) reported rechecking an initially high blood pressure on two or three occasions before starting treatment, 56% (202) measured sitting blood pressure only, and just 28% (100) took sitting and standing levels. 36% (128) had no upper age limit for starting anti-hypertensive treatment; of the 58% (206) who did, the median was 80 (range 70-99) years. Blood pressure levels reported for starting treatment in patients aged 70-79 years were 180 (150-240)/106 (90-120) mm Hg. 34% of general practitioners (121) would not treat isolated systolic hypertension. The most popular first line treatment for an elderly hypertensive patient was a thiazide diuretic; only 17% of general practitioners (61) initially tried non-pharmacological methods. 34% (122) would continue anti-hypertensive treatment unchanged in the period immediately after stroke.


CONCLUSIONS
The variation among general practitioners in the criteria for the measurement, diagnosis, and treatment of hypertension in elderly patients emphasises the need for clear management guidelines in this age group.
University Department of Medicine for the Elderly, Leicester General Hospital.
M D
MD
Fotherby
G D
GD
Harper
J F
JF
Potter
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001581:Benzothiadiazines; D001795:Blood Pressure Determination; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002561:Cerebrovascular Disorders / Q000517:prevention & control; D004232:Diuretics; D005194:Family Practice; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D010821:Physicians, Family / Q000523:psychology*; D049993:Sodium Chloride Symporter Inhibitors / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D001581:Benzothiadiazines; D002121:Calcium Channel Blockers; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors