Hypotension--does it make sense in family practice?
In general practice many diagnostic labels are used that are related to cultural background rather than a scientific basis. To estimate the use of diagnoses like 'hypotension' and depression, a cross-sectional survey in German and British GPs' surgeries was performed. Prevalence of related symptoms, sociodemographic and medical data were recorded as well as actual and previous blood pressure levels. In German general practice, where 'hypotension' is an established entity, 17% of all patients attending were reported as hypotensive either by their doctor or by themselves. The proportion was twice as high among women than among men. It was more common among the young. One-quarter of these patients were on medication to raise their blood pressure. Actual and previous blood pressure levels failed to explain the occurrence of symptoms like tiredness, dizziness, headache etc. Demographic characteristics of patients diagnosed as depressed were similar in both countries. Presumably for economic reasons there is a tendency for German GPs to use more diagnostic labels of any kind. It was concluded that diagnostic labels attached to vague but frequently presented symptoms vary considerably between countries. They often lack a physiologic rationale. Nevertheless they often support the tendency to somatize common problems.
Donner-Banzhoff
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Department of Family and Community Medicine, Sunnybrook Health Science Centre, University of Toronto, North York, Ontario, Canada.
Kreienbrock
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L
Baum
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E
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001291:Attitude of Health Personnel; D001794:Blood Pressure / Q000502:physiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D004244:Dizziness / Q000453:epidemiology; D005194:Family Practice; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006261:Headache / Q000453:epidemiology; D006801:Humans; D007022:Hypotension / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors; D006113:United Kingdom / Q000453:epidemiology