Awareness and Approach towards Hypertension Management among General Practitioners of Western Vadodara (original) (raw)
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Detection and treatment of hypertension in general health-care practice: a patient-based study
Journal of Human Hypertension, 2005
The aim of this study was to describe the pattern of blood pressure (BP) distribution in a multiethnic primary care practice in relation to sociodemographic characteristics, lifestyle and risk factors. Another aim was to analyse the quality of diagnosis and effectiveness of hypertension (HT) treatment. In all, 470 adult patients (X16 years old) who visited the Jordbro Health Centre (JHC), Haninge Municipality, participated in this study. A general questionnaire with questions about sociodemographic characteristics, lifestyle, health status and chronic disease was used. Medical records: information on consultations with the general practitioner and prescriptions were collected from the medical records for the year 2001. Furthermore, a medical examination was performed: this consisted of weight, height, systolic (SBP) and diastolic (DBP) blood pressure, and labora-tory analyses including fasting blood glucose, serum cholesterol, serum triglycerides, electrocardiogram and spirometry. Out of 464 patients, 114 (24.6%) reported HT. Among the HT patients, 93 (81.6%) had SBP X140 mmHg and 52 (45.6%) DBP X90 mmHg. Among the nonhypertensive patients (n ¼ 350), 120 (34.3%) had SBP X140 mmHg and 50 (14.3%) DBP X90 mmHg. Furthermore, there are some patients with high BP who are unknown or undetected. HT treatment among this population is unsatisfactory and greater efforts are required to identify people with high BP and to ensure that they are managed according to the best available evidence.
CardioVascular Journal of Africa, 2011
Background: Patient-and physician-related factors impact on the management and control of hypertension. Objectives: To systematically examine: (1) South African primary care doctors' state of knowledge on the management of hypertension; (2) primary health practitioners' knowledge on the South African hypertension guidelines; (3) current approaches to management of hypertensive patients; and (4) challenges to effective management of hypertension at primary level. Methods: A cross-sectional, observational study using a semi-structured questionnaire was carried out in two large community health centres (CHCs) in the Cape Town metropole. All 16 doctors employed at both CHCs were voluntarily enrolled, seven (43.7%) of whom were female, with 14 (87.5%) younger than 40 years of age. The majority (81.2%) of the doctors surveyed had been practicing for less than 10 years. Results: Ten (62.5%) of the doctors surveyed aimed to treat hypertension to target, and recommendations on lifestyle modifications were reportedly poorly done. While 11 (68.8%) of the doctors were aware of the South African hypertension guidelines, were (81.8%) of them were not conversant with the contents thereof. Doctors estimated that only 35% of their patients are treated to target. Poor patient adherence to prescribed treatment, language difficulty, heavy patient load, medical staff shortages, and patient loss to follow up were identified by the doctors as significant impediments to the effective management of hypertension at the primary level of care. Conclusion: Primary healthcare practitioners' knowledge regarding hypertension and the South African hypertension guidelines is poor. Management of hypertension by these doctors is sub-optimal. There are significant challenges to effective management of hypertension at this level of care.
Prevalence, risk factors and awareness of hypertension in India: a systematic review
Journal of Human Hypertension, 2013
Indians have high rates of cardiovascular disease. Hypertension (HTN) is an important modifiable risk factor. There are no comprehensive reviews or a nationally representative study of the burden, treatments and outcomes of HTN in India. A systematic review was conducted to study the trends in prevalence, risk factors and awareness of HTN in India. We searched MEDLINE from January 1969 to July 2011 using prespecified medical subject heading (MeSH) terms. Of 3372 studies, 206 were included for data extraction and 174 were observational studies. Prevalence was reported in 48 studies with sample size varying from 206 to 167 331. A significant positive trend (Po0.0001) was observed over time in prevalence of HTN by region and gender. Awareness and control of HTN (11 studies) ranged from 20 to 54% and 7.5 to 25%, respectively. Increasing age, body mass index, smoking, diabetes and extra salt intake were common risk factors. In conclusion, from this systematic review, we record an increasing trend in prevalence of HTN in India by region and gender. The awareness of HTN in India is low with suboptimal control rates. There are few long-term studies to assess outcomes. Good quality long-term studies will help to understand HTN better and implement effective prevention and management programs.
General Practitioners' Approach to Hypertension in Urban Pakistan: Disturbing Trends in Practice
Circulation, 2005
Background-Control of blood pressure (BP) remains suboptimal worldwide. The objective of this study was to determine whether (primary) general practitioners' (GPs) approach to high BP is in accordance with international guidelines. Methods and Results-We conducted a cross-sectional survey of 1000 randomly selected GPs from urban areas in Pakistan during 2002. A rigorously developed questionnaire on (1) type of practice and (2) detection, (3) evaluation, (4) treatment, and (5) source of information about high BP was administered by trained medical personnel. A total of 1051 GPs were approached, and 1000 (95%) consented to enroll; 766 were male and 655 had been in practice Ն10 years. The average number of patients (SD) seen per day was 48.2 (42.7). Overall, 30.6% (29.0% to 32.3%) and 79.7% (78.3% to 81.0%) of GPs used incorrect BP cutoffs to diagnose hypertension in patients Ͻ60 and Ն60 years, respectively. Appropriate therapy for hypertension in the elderly was initiated by only 34.7% (33.0% to 36.3%) of GPs. The use of sedatives either alone (23.8%) or in combination with antihypertensive agents as first-line medication for lowering BP was reported by 45.0% (43.2% to 46.7%). Thiazide diuretics were rarely prescribed (4.2%). Sublingual antihypertensive agents were prescribed by 68.7% (67.1% to 70.3%) of GPs for treating very high levels of BP. The practices of recent graduates from medical school were not better than those of older graduates. Conclusions-GPs in Pakistan underdiagnose and undertreat high BP, especially in the elderly. Our findings underscore the need for urgent revision of teaching curricula in medical schools with regard to the risks, complications, and management of hypertension, as well as the initiation of widespread and intensive continuing medical education for all physicians involved in the management of patients with hypertension. Particular efforts are needed to encourage the use of low-cost thiazide diuretics as antihypertensive agents in developing countries.
Prevalence and Management of Hypertension along with its Complications - A Prospective Study
Journal of Pharmaceutical Research International, 2021
Aim: The main aim of the study was to estimate the prevalence of hypertension and correlate hypertension with the occurrence of its complications. Study Design: The study was designed to detect the adverse outcomes of uncontrolled hypertension and review the treatment patterns in the management of hypertension along with the complications. Place and Duration of the Study: This study was an observational study conducted for a period of six months from January to June 2020, at THUMBAY HOSPITAL NEW LIFE, in an inpatient department. Methodology: Using a suitable designed data form, details of the patient were collected from patient demographics, prescription charts, laboratory data, medical records, doctor's and nursing notes. Results: In this study, the prevalence of hypertension was found to be more in males (52.5%) than in females (47.5%). Among all age groups, individuals aged 50-59 yrs were highly affected. From the study, it was found that a greater number of patients fall in ...
A study of hypertension epidemiology among urban population of Malwa region, India
International Journal of Research in Medical Sciences, 2016
Background: Hypertension (HTN) is the leading risk factor for cardiovascular disease and mortality worldwide. Almost three quarters of individuals with HTN live in developing countries with limited health resources and where people have low awareness of HTN and limited access to health care. Our study was thus designed to determine the prevalence, awareness, treatment, and control rates of HTN. Methods: We conducted a cross-sectional survey in different areas of urban Indore. Inclusion criteria were adults older than 21 years who gave oral consent to participate. There were no exclusion criteria. Data were collected on demographic variables, socioeconomic status, presence of other cardiovascular risk factors, and medication use. BP was measured after at least 10 minutes of rest in the sitting position. Data analysis was done with Statistical Product and Service Solutions (SPSS) Statistics version 17.0 (Chicago IL, USA). Results: From December 2014 to May 2015, a total of 1697 participants were enrolled in the study. Their mean age was 42.9 years and 56% were men. The crude prevalence of HTN in our study was 36.9%. The prevalence of HTN was higher in men compared with women and increased with increasing age groups. In addition, HTN was more prevalent in patients who smoked, patients with diabetes, patients with higher BMI, and those who were married, divorced, or widowed compared with singles. HTN awareness was 53%. Among "aware" participants, 93% were taking BP-lowering therapy. Among treated participants, 54% had their BP under control during the examination. This translates into an overall 27% control rate when all hypertensive patients were considered (treated and not treated). Conclusions: Our results confirm the importance of the HTN epidemic; only one third of participants have optimal BP levels and the remaining two thirds are either hypertensive or prehypertensive. Men in particular are severely affected by the disease: 43% and 35% have either HTN or pre-HTN. Their awareness, treatment, and overall control rates are lower than those of women.
SAS journal of medicine, 2022
Original Research Article Hypertension is a condition where the blood pressure is elevated. It occurs worldwide with an increasing incidence rate year by year, therefore still is an interesting topic of research as an effort to manage this disease. Long term uncontrolled high blood pressure may lead to several complications such as cardiovascular diseases, kidney disease and stroke. Monitoring blood pressure regularly and patients' adherence to medication will lower the risk of complications. This study aims to explore the blood pressure of patients with hypertension at Kawiley and their adherence to taking anti hypertension drugs. This is an analytical descriptive survey with cross sectional approach. Respondents have been recruited from primary health care facilities. Blood pressures were taken according to standardized operation procedure using a digital measurement. Medication usage have been recorded, tabulated and analyzed. Results show from 54 respondents, consisting of 16 (29.6%) male and 38 (70.4%) female with the average age of 64 years old. Average systolic blood pressure (SBP) for all respondents is 133.5 mmHg and diastolic blood pressure (DBP) is 83.4 mmHg, with no big differences amongst the gender. About 18 respondents have systolic BP higher than 140mmHg (average 148.4mmHg) and 13 respondents with diastolic BP more than 90mmHg (average 94.1mmHg). (41 of the 54 respondents) consistently take their medications as prescribed. Systolic blood pressure of those who are not consistent with their antihypertension medications is greater than 130 mmHg. Most of the respondents only use one type of calcium channel blocker as an antihypertension medication. In conclusion, most respondents stick to taking their medications as directed, and the average blood pressure among respondents with hypertension is within the normal range. It is advised that hypertensive patients periodically check their blood pressure to prevent serious problems.
Effective Management of Hypertension: A Cross-Sectional Study of Five Health Facilities
Research Square (Research Square), 2024
Background Hypertension remains a signi cant global health concern due to its high incidence and association with cardiovascular diseases, stroke, and other complications. This research aimed to determine the dynamics of blood pressure control over the course of disease management, focusing on the systolic and diastolic readings at baseline and at the time of the study and on the number of years of patient management and sex. Methods A retrospective study with a multicenter approach was used. The information of a total of 373 patients was collected and analyzed using Python and SPSS. Results Overall, 72.9% of the patients were female, and 27.1% were male. The mean age was 62.57 ± 0.635 years. A regression model was used to evaluate the associations between the number of years of hypertension management, systolic anddiastolic BP at rst diagnosis and current systolic and diastolic BP at R-square, (13.2% and 29.2%, respectively; p<0.01). There was a signi cant reduction in the systolic BP before (M = 157.01 ± 28.159) compared to after (M =138.07 ± 19.591), t (372) = 12.959, p <0.001. Similarly, the results showed a signi cant reduction in the diastolic BP of the patients before (M = 91.85 ± 15.934) compared to after (M =85.19 ± 12.955), t (372) = 9.062, p <0.001. There was a greater systolic BP at rst diagnosis in males than in females. Conclusions The number of years of hypertension management and BP at rst diagnosis may be associated with the outcome of management. Appropriate treatment combinations involving two classes of antihypertensive drugs may encourage patient adherence and yield positive outcomes.