Physiciansʹ approach to the management of hypertension in a developing community

General physiciansʹ (GP) approach to the management of hypertension was assessed by a standard questionnaire. Each of the 42 physicians studied see about 42 patients in a clinic day. Over half do not usually measure the blood pressure (BP) of all new patients. A third do not investigate before starting therapy. Over half commence drug therapy with less than three BP readings, while over two thirds do so from appropriate BP levels. Over 70% employ sedatives in treatment (50% as the only initial therapy); 45% employ parenteral drugs from a diastolic BP of 110 mmHg. Over 40% do not educate their patients on the implications of hypertension and the need for regular treatment and follow-up, but most give follow-up appointments. Patients are requested to stop therapy once BP is normalised by 25.9% of GPs. These practices were not significantly influenced by years of experience or by being a GP in a teaching hospital system (P > 0.1 and P > 0.5, respectively). The study suggests that physician recognition and management of hypertension is still inadequate and this might in part be related to a general heavy patient load. In addition, continued medical education is essential for physicians for the purpose of improving our management skills.