A survey of management practices for isolated systolic hypertension.
OBJECTIVE
To determine the management practices of clinicians for patients with isolated systolic hypertension, with particular attention to treatment thresholds, medication choices, and target blood pressures.


METHODS
Self-administered questionnaire.


METHODS
Edmonton, Alberta, a large Canadian city.


METHODS
A random sample of 348 family physicians and 125 internists.


METHODS
Demographics of the respondents, first and second choice of antihypertensives, treatment thresholds, and target blood pressures for patients with isolated systolic hypertension.


RESULTS
Excluding 54 nondeliverable questionnaires, a response rate of 67% (281 surveys) was obtained. The responding clinicians reported treatment thresholds and target blood pressures consistent with the evidence from randomized clinical trials and the recommendations of the Canadian Hypertension Society and the Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Thiazide diuretics were recommended as first line therapy by 74% of internists and 58% of family physicians. Angiotensin converting enzyme inhibitors were the most frequently chosen second line drug (27% of internists and 45% of family physicians).


CONCLUSIONS
The reported management practices of this group of clinicians are consistent with the evidence from randomized clinical trials and the recommendations of national consensus guidelines.
McAlister
F A
FA
Division of General Internal Medicine, University of Alberta, Canada.
Teo
K K
KK
Laupacis
A
A
D000328:Adult; D000416:Alberta; D000959:Antihypertensive Agents / Q000145:classification / Q000627:therapeutic use; D001794:Blood Pressure; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D005194:Family Practice / Q000379:methods*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007388:Internal Medicine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013599:Systole; D014504:Urban Health
D000959:Antihypertensive Agents