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[Local variability in the guidelines for hypertension screening, diagnosis and baseline assessment in 40 health centers].

Abstract：

BACKGROUND:To identify and to compare the recommendations of the currently existing clinical protocols for arterial hypertension (HT) screening, diagnosis and baseline study in the Murcia Region, Spain, in order to assess their validity and reliability. MATERIAL AND METHODS:Structured comparative description of guidelines in Clinical Protocols for HT (n = 40) from all Health Centers in the Region. Comparative description of the Health Centers Clinical Protocols and national and international reference documents regarding HT screening, diagnosis and baseline assessment is performed. RESULTS:Target population for screening ranged from aged > or = 14 years (24 centers) to > 20 (1 center). Screening procedure was not described in 3 centers and screening periodicity varied from 6 months to 5 years, with differences by age and by concurrent risk factors in some protocols. Diagnosis norms differed by age in only 11 protocols; blood pressure (BP) exams for diagnosis varied from 3 to 5 and there were 12 different HT figures for immediate diagnosis and treatment. Baseline study varied greatly; we found a total of 7 recommended items for anamnesis, 11 for physical exam, 19 for blood tests, 4 for urine tests, and 7 for other tests; only the electrocardiogram was common to all protocols. There was also some disagreement in the national and international reference guidelines whose scientific evidence was not always explicitly considered. CONCLUSIONS:There is a wide local variation in norms for HT screening, diagnosis, and baseline study. If the Centers follow their own protocols, the same patient may be or may not be diagnosed depending on the Center he visits; additionally, there would be big differences in the process and resources needed for HT control. This variation casts doubt on the protocols validity and reliability at regional level and underscores the need for critically reviewing the validity of existing protocols.

journal_name

Med Clin (Barc)

journal_title

Medicina clinica

authors

Saturno Hernández PJ,Antón Botella JJ,Murcia Payá JF

keywords:

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

14-8

eissn

0025-7753

issn

1578-8989

journal_volume

114 Suppl 2

pub_type

杂志文章

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[Local variability in the guidelines for hypertension screening, diagnosis and baseline assessment in 40 health centers].