title: Medical practitioners' views on the management of hypertension in Trinidad and Tobago.
abstract: We surveyed 161 medical practitioners in Trinidad and Tobago (124 reporting private sector practice and 37 describing government health centre practice) for their views on blood pressure (BP) management. 96% of the respondents agreed that BP should be measured on all adults seen and 90% agreed that diastolic pressure should be recorded as the disappearance of sounds. There was disagreement over the level of diastolic BP at which drug treatment should be initiated: 63% would treat diastolic BP less than 100 mm Hg, but 35% would only treat diastolic BP of 110 mm Hg or higher. In private practice 31% preferred angiotensin converting enzyme (ACE) inhibitors as treatment for an African Caribbean man with diastolic BP 110 mm Hg, but in public clinics 41% preferred thiazide diuretics. ACE inhibitors were most often preferred as treatment for an Indo-Caribbean man with diabetes and diastolic BP 110 mm Hg in both public and private practice. Doctors considered that noncompliance (66%), lack of education (34%) and unhealthy lifestyles (25%) were important obstacles to BP control. In private practice doctors considered patients' financial constraints to be an obstacle (58%), whereas in the public sector limited availability of drugs (57%) was felt to be more important. Less costly and, possibly, more appropriate drugs were used in public clinics.
authors.affiliation: Nutrition Division, Ministry of Health, Trinidad and Tobago.
authors.forename: D
authors.initials: D
authors.lastname: Mahabir
authors.forename: M C
authors.initials: MC
authors.lastname: Gulliford
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001794:Blood Pressure; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008297:Male; D014300:Trinidad and Tobago