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Lack of adherence to hypertension treatment guidelines among GPs in southern Sweden-A case report- based survey

Ekesbo, Rickard LU ; Midlöv, Patrik LU ; Gerward, Sofia LU ; Persson, Kristin LU ; Nerbrand, Christina LU and Johansson, Lennart (2012) In BMC Family Practice 13.
Abstract
Background: General practitioners (GPs) often fail to correctly adhere to guidelines for the treatment of hypertension. The reasons for this are unclear, but could be related to lack of knowledge in assessing individual patients' cardiovascular disease risk. Our aim was to investigate how GPs in southern Sweden adhere to clinical guidelines for the treatment of hypertension when major cardiovascular risk factors are taken into consideration. Method: A questionnaire with five genuine cases of hypertension with different cardiovascular risk profiles was sent to a random sample of GPs in southern Sweden (n = 109) in order to investigate the attitude towards blood pressure (BP) treatment when major cardiovascular risk factors were present.... (More)
Background: General practitioners (GPs) often fail to correctly adhere to guidelines for the treatment of hypertension. The reasons for this are unclear, but could be related to lack of knowledge in assessing individual patients' cardiovascular disease risk. Our aim was to investigate how GPs in southern Sweden adhere to clinical guidelines for the treatment of hypertension when major cardiovascular risk factors are taken into consideration. Method: A questionnaire with five genuine cases of hypertension with different cardiovascular risk profiles was sent to a random sample of GPs in southern Sweden (n = 109) in order to investigate the attitude towards blood pressure (BP) treatment when major cardiovascular risk factors were present. Results: In general, GPs who responded tended to focus on the absolute target BP rather than assessing the entire cardiovascular risk factor profile. Thus, cases with the highest risk of cardiovascular disease were not treated accordingly. However, there was also a tendency to overtreat the lowest risk individuals. Furthermore, the BP levels for initiating pharmacological treatment varied widely (systolic BP 140-210 mmHg). ACE inhibitors (70%) were the most common first choice of pharmacological treatment. Conclusion: In this study, GPs in Southern Sweden were suggesting, for different cases, either under- or overtreatment in relation to current guidelines for treatment of hypertension. On reason may be that they failed to correctly assess individual cardiovascular risk factor profiles. Key points: Despite international and national clinical guidelines on the treatment of hypertension, general practitioners often fail to correctly assess the cardiovascular risk for patients in a clinical setting. Most GPs use target blood pressure levels but do not consider other cardiovascular risk factors. Both under- and overtreatment of high and low cardiovascular risk groups were seen in this study. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Hypertension, Adherence, Guidelines, Treatment, Primary care
in
BMC Family Practice
volume
13
publisher
BioMed Central
external identifiers
  • wos:000306291800001
  • scopus:84862196441
ISSN
1471-2296
DOI
10.1186/1471-2296-13-34
language
English
LU publication?
yes
id
87f901e0-196a-437b-931c-62eef2ecaa6f (old id 3001271)
date added to LUP
2012-09-03 07:18:58
date last changed
2017-07-30 04:01:13
@article{87f901e0-196a-437b-931c-62eef2ecaa6f,
  abstract     = {Background: General practitioners (GPs) often fail to correctly adhere to guidelines for the treatment of hypertension. The reasons for this are unclear, but could be related to lack of knowledge in assessing individual patients' cardiovascular disease risk. Our aim was to investigate how GPs in southern Sweden adhere to clinical guidelines for the treatment of hypertension when major cardiovascular risk factors are taken into consideration. Method: A questionnaire with five genuine cases of hypertension with different cardiovascular risk profiles was sent to a random sample of GPs in southern Sweden (n = 109) in order to investigate the attitude towards blood pressure (BP) treatment when major cardiovascular risk factors were present. Results: In general, GPs who responded tended to focus on the absolute target BP rather than assessing the entire cardiovascular risk factor profile. Thus, cases with the highest risk of cardiovascular disease were not treated accordingly. However, there was also a tendency to overtreat the lowest risk individuals. Furthermore, the BP levels for initiating pharmacological treatment varied widely (systolic BP 140-210 mmHg). ACE inhibitors (70%) were the most common first choice of pharmacological treatment. Conclusion: In this study, GPs in Southern Sweden were suggesting, for different cases, either under- or overtreatment in relation to current guidelines for treatment of hypertension. On reason may be that they failed to correctly assess individual cardiovascular risk factor profiles. Key points: Despite international and national clinical guidelines on the treatment of hypertension, general practitioners often fail to correctly assess the cardiovascular risk for patients in a clinical setting. Most GPs use target blood pressure levels but do not consider other cardiovascular risk factors. Both under- and overtreatment of high and low cardiovascular risk groups were seen in this study.},
  author       = {Ekesbo, Rickard and Midlöv, Patrik and Gerward, Sofia and Persson, Kristin and Nerbrand, Christina and Johansson, Lennart},
  issn         = {1471-2296},
  keyword      = {Hypertension,Adherence,Guidelines,Treatment,Primary care},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Family Practice},
  title        = {Lack of adherence to hypertension treatment guidelines among GPs in southern Sweden-A case report- based survey},
  url          = {http://dx.doi.org/10.1186/1471-2296-13-34},
  volume       = {13},
  year         = {2012},
}