Family Practice Vol. 20, No. 6, 733
© Oxford University Press 2003, all rights reserved
Correspondence |
Hypertension in a primary care setting
St George's Hospital Medical School, London SW17 0RE, UK
Correspondence to David Evans, 12 Lovell House, Abbey Road, Colliers Wood, London SW19 2LL; Email: ms994240{at}sghms.ac.uk
In their cross-sectional analysis of computerized GP data, Pears et al. found that male hypertensive patients were more likely than females to receive an ACE inhibitor or a statin.1 They also found elderly patients were less likely than younger patients to be under GP active review. We decided to investigate knowledge of hypertension in men over 50 attending one general practice during a two week period in December 2002.
The study took the form of a short six item questionnaire that was given to all patients within the target group. The questionnaire aimed to assess their knowledge of the health risks and treatments of hypertension as well as what lifestyle changes can lower blood pressure. We also asked when they last had their blood pressure checked and whether they had ever been treated for high blood pressure. We then compared the difference in knowledge between hypertensive and normotensive individuals.
The response rate was 89% (115/129) with the mean age of respondents being 67 years (range 50–85). As expected there was a difference in the knowledge of the possible treatments of hypertension (e.g. medication, increased exercise, weight loss etc.) with 89.6% (43/48) of hypertensive and only 68.7% (46/67) of normotensive individuals providing at least one correct answer (P < 0.01). However, when it came to lifestyle changes that could lower blood pressure (low salt diet, loss of weight, increased exercise, stopping smoking etc) 85.4% (41/48) of hypertensives and 79.1% (53/67) of normotensives provided at least one correct answer. This difference was not significant (P = 0.4).
These results show a fairly high level of knowledge concerning hypertension among men over 50 attending this general practice surgery. However we would like to see an even greater level of knowledge, especially among the hypertensive group. As Pears et al. mention, the rule of halves still applies, with only about half of known hypertensives receiving treatment having their blood pressure adequately controlled.2 One of the cornerstones to achieving adequate blood pressure control is patient education. Therefore this must come at the forefront of blood pressure management in primary care.
Acknowledgments
We would sincerely like to thank the staff and patients of St Johns Health Centre, Woking, for all their assistance.
References
1 Pears E, Hannaford PC and Taylor MW. Gender, age and deprivation differences in the primary, care management of hypertension in Scotland: a cross-sectional database study. Fam Pract 2003; 20: 22–30.
2 Hooker RC, Cowap N, Newson R, Freeman GK. Better by half: hypertension in the elderly and the ‘rule of halves’: a primary are audit of the clinical computer record as a springboard to improving care. Fam Pract 1999; 16: 123–128.
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