title: Awareness and Approach towards Hypertension Management among General Practitioners of Western Vadodara.
abstract: BACKGROUND
  Hypertension (HTN) is a major risk factor contributing to premature mortality from cardiovascular and cerebrovascular disease.To decrease morbidity and mortality from HTN, timely diagnosis of the disease and its complications, urgent treatment and referrals are required. General Practioners (GPs) are the first tier of the health care system in India and have a wide scope of practice. It is important to know the awareness and approach of primary care physicians to hypertension in their daily practice as compared to standard practice recommendations and guidelines, to identify targets for improvements. With this objective we decided to interview them personally and analyse their approach.
  
  
  METHODS
  We conducted a cross-sectional survey in 80 general practitioners (GPs) of the western part of Vadodara city with the use of a questionnaire prepared from JNC-7 guidelines and standard medical books. Seventy seven [97.55%] GPs completed the questionnaire and their responses were statistically analysed.
  
  
  RESULTS
  Twenty percent of GPs were not applying BP cuff properly for BP measurement. Only 18% and 16.6 % could diagnose isolated diastolic hypertension (IDH) and isolated systolic hypertension respectively (ISH) and 21% and 29% would have considered treatment of IDH and ISH respectively.48% consider treating pre-hypertension using non-pharmacological measures. Only 21% use thiazide diuretics for uncomplicated HTN and 50% use beta-blockers in coronary artery disease patients.
  
  
  CONCLUSIONS
  In our study, most of the GPs in western Vadodara are well aware and updated about the initial lab investigations,non-pharmacological measures and complications of HTN but lack an effective approach towards history taking for HTN,technique for measurement of blood pressure, diagnosis and treatment of IDH and ISH. Pre-hypertension and systolic and diastolic hypertension is under-treated and thiazide diuretics are underutilized. This study can be used to identify targets and approaches to improve hypertension management at the primary care level.
authors.affiliation: Assistant Professor, Department of Medicine, Gujarat Medical Education and Research Society , Gotri, Vadodara, India .
authors.forename: Shubhangi
authors.initials: S
authors.lastname: Deshpande
authors.affiliation: Resident, Department of Internal Medicine, Brookdale University Hospital and Medical Center , New York, United States .
authors.forename: Niyati
authors.initials: N
authors.lastname: Patel
authors.affiliation: Professor, Department Of Medicine, Gujarat Medical Education and Research Society , Gotri, Vadodara, India .
authors.forename: Varsha
authors.initials: V
authors.lastname: Godbole
authors.affiliation: Junior Resident, Gujarat Medical Education and Research Society , Gotri, Vadodara, India .
authors.forename: Viral
authors.initials: V
authors.lastname: Champaneri
authors.affiliation: Junior Resident, Gujarat Medical Education and Research Society , Gotri, Vadodara, India .
authors.forename: Niraj
authors.initials: N
authors.lastname: Singh
authors.affiliation: Senior Resident, Medical College Baroda, Vadodara, India .
authors.forename: Rushad
authors.initials: R
authors.lastname: Patell
keywords: General practitioners; Hypertension; MRSA; Management