Treatment of Arterial Hypertension by the GeneralPractitioner: Results of a Nationwide Trial

Overview

The objective of the investigation was to assess the characteristic of hypertonic patients treatedby general practitioners, the standard of check-ups of blood pressure (BP) and the type ofantihypertensive drugs used. The authors selected 290 general practitioners from the CzechRepublic, each of them provided data on eight patients treated on account of hypertension. Dataon 2322 hypertonic patients were assembled, mean age 58.5 years, 48.4 % were males. Thegroup comprised 18.6 % subjects who smoked regularly. The mean body mass index was 28.9kg/m 2. The basic laboratory parameters (total cholesterol, blood sugar level, creatinine) wereexamined in some 90 % of the probands during the past two years, the mean cholesterol levelwas 6.0 mmol/l. The mean BP in a sitting position assessed in the surgery was 145/86 mm Hg.Assessment of the BP by their own tonometer at home was reported by 10.9 % patients. As toantihypertensive drugs 26 % were beta-blockers, 22 % diuretics, 22 % ACE inhibitors, 20 % Caantagonists, 5 % combined preparations, 3 % centrally acting antihypertensive drugs and 1 %alpha-blockers. The non-retarded form of nifedipine was used by 6.2 % of all patients. Hyper-tonic patients with a history of myocardial infarction or angina pectoris resp. used beta-blockersonly in 45 % and 43 % resp.The investigation indicates that a relatively large number of patients treated on account ofhypertension are regular smokers. The prevalence of overweight is also high, one quarter of thepatients are obese. Assessment of the BP in the patients’ home is not frequent. Short-actingnifedipine is despite its unsuitable character still a popular antihypertensive drug. Beta-bloc-kers are used surprisingly little in patients with ischaemic heart disease.

Key words:
arterial hypertension - treatment - nationwide trial - general practitioner.