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)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3001271
- author
- Ekesbo, Rickard
LU
; Midlöv, Patrik
LU
; Gerward, Sofia
LU
; Persson, Kristin
LU
; Nerbrand, Christina
LU
and Johansson, Lennart
- organization
- publishing date
- 2012
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Hypertension, Adherence, Guidelines, Treatment, Primary care
- in
- BMC Family Practice
- volume
- 13
- publisher
- BioMed Central (BMC)
- external identifiers
-
- wos:000306291800001
- scopus:84862196441
- pmid:22536853
- 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
- 2016-04-01 13:19:53
- date last changed
- 2022-04-01 02:29:36
@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}},
keywords = {{Hypertension; Adherence; Guidelines; Treatment; Primary care}},
language = {{eng}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Family Practice}},
title = {{Lack of adherence to hypertension treatment guidelines among GPs in southern Sweden-A case report- based survey}},
url = {{https://lup.lub.lu.se/search/files/3306567/3126078.pdf}},
doi = {{10.1186/1471-2296-13-34}},
volume = {{13}},
year = {{2012}},
}