Physicians' approach to the management of hypertension in a developing community.
General physicians' (GP) approach to the management of hypertension was assessed by a standard questionnaire. Each of the 42 physicians studied see about 42 patients in a clinic day. Over half do not usually measure the blood pressure (BP) of all new patients. A third do not investigate before starting therapy. Over half commence drug therapy with less than three BP readings, while over two thirds do so from appropriate BP levels. Over 70% employ sedatives in treatment (50% as the only initial therapy); 45% employ parenteral drugs from a diastolic BP of 110 mmHg. Over 40% do not educate their patients on the implications of hypertension and the need for regular treatment and follow-up, but most give follow-up appointments. Patients are requested to stop therapy once BP is normalised by 25.9% of GPs. These practices were not significantly influenced by years of experience or by being a GP in a teaching hospital system (P > 0.1 and P > 0.5, respectively). The study suggests that physician recognition and management of hypertension is still inadequate and this might in part be related to a general heavy patient load. In addition, continued medical education is essential for physicians for the purpose of improving our management skills.
Dept of Medicine, Obafemi Awolowo College of Health Sciences, Ogun State University Teaching Hospital, Shagamu, Nigeria.
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D000959:Antihypertensive Agents / Q000627:therapeutic use; D001071:Appointments and Schedules; D001291:Attitude of Health Personnel; D001794:Blood Pressure; D003906:Developing Countries; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000193:education; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D009549:Nigeria; D010353:Patient Education as Topic; D010361:Patients; D010817:Physician-Patient Relations; D010820:Physicians; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D011364:Professional Practice; D013997:Time Factors
D000959:Antihypertensive Agents; D006993:Hypnotics and Sedatives