Do Brazilian physicians follow the Brazilian guidelines on hypertension?

Abstract:

OBJECTIVE:To evaluate whether procedures adopted by Brazilian physicians in the diagnosis and treatment of hypertension are in compliance with those advocated by the IV Brazilian Hypertension Guidelines. METHOD:Survey carried out by means of telephone interviews with Brazilian physicians. The survey featured application of a questionnaire aimed to assess receipt of and compliance with the guidelines, and to evaluate various aspects regarding the treatment of hypertensive patients. RESULTS:68.3% of the respondents had received the guidelines and answered the questionnaire in full. The total sample consisted of 483 physicians--47% cardiologists, 31.7% internists, and 21.3% nephrologists. The survey showed high compliance with certain guideline topics such as more than one measurement at different times for the diagnosis of hypertension (94%), and providing guidance regarding lifestyle changes as a therapeutic strategy. As to arterial pressure levels used for diagnosis and therapeutic target, compliance with guideline recommendations lacks uniformity. The survey showed a clear preference for pressure levels lower than those recommended, especially in patients with comorbidities. Attempts to assess cardiovascular risk also proved to be low. Only 64.7% of the respondents reported that they seek to determine the presence of diabetes mellitus, and 56.4% check for dyslipidemia. The majority (59.3%) mentioned diuretics as the preferred drug class for initial drug treatment of hypertension. CONCLUSION:We concluded that there is only partial compliance with Brazilian Hypertension Guidelines and that certain factors should be taken into consideration when drawing up future guidelines, such as: improved distribution; standardization of values for diagnosis and therapeutic target; more extensive coverage of ways for physicians to approach hypertensive patients to better evaluate their overall cardiovascular risk.

journal_name

Arq Bras Cardiol

authors

Mion D Jr,da Silva GV,de Gusmão JL,Machado CA,Amodeo C,Nobre F,Praxedes JN,Mota MA

doi

10.1590/s0066-782x2007000200013

subject

Has Abstract

pub_date

2007-02-01 00:00:00

pages

212-7

issue

2

eissn

0066-782X

issn

1678-4170

pii

S0066-782X2007000200013

journal_volume

88

pub_type

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