Huse D M, Roht L H, Alpert J S, Hartz S C
Clinical and Analytical Operations, Pharmetrics, Inc, Watertown, MA 02472-2815, USA.
Ann Pharmacother. 2001 Oct;35(10):1173-9. doi: 10.1345/aph.10204.
To explore how well physicians who treat hypertension know the indications and contraindications for particular antihypertensive therapies, and how closely their opinions and practice of hypertension treatment agree with national guidelines.
We surveyed by mail a stratified random sample of 10,000 US cardiologists, internists, and general/family practitioners. This survey explored their knowledge, attitudes, and practices with respect to the treatment of hypertension. Responses were compared with national guidelines and product labeling at the time of the survey. Results were stratified by physician specialty.
A total of 1,023 physicians, or 10.2% of the sample, responded to the survey. Only 37.3% answered all four knowledge questions correctly, including 25.7% of general/family practitioners, 38.3% of internists, and 49.5% of cardiologists (p < 0.001). In their attitudes with respect to evaluating high blood pressure and establishing treatment goals, most respondents agreed with established guidelines. However, when asked how they would treat uncomplicated, mild hypertension, only 23% limited their selection to diuretics and beta-blockers in accordance with the guidelines. Cardiologists in particular were more likely than internists or general/family practitioners to choose other drug classes, such as angiotensin-converting enzyme Inhibitors or calcium-channel blockers.
The results of our survey suggest that national efforts to educate physicians about the increasingly complex armamentarium for hypertension, and to persuade them to base their prescribing on the results of randomized, controlled trials of primary prevention, must be continued.
探讨治疗高血压的医生对特定抗高血压疗法的适应证和禁忌证的了解程度，以及他们在高血压治疗方面的观点和实践与国家指南的符合程度。
我们通过邮件对10000名美国心脏病专家、内科医生以及普通/家庭医生进行分层随机抽样调查。该调查探讨了他们在高血压治疗方面的知识、态度和实践。将调查结果与调查时的国家指南和药品标签进行比较。结果按医生专业进行分层。
共有1023名医生（占样本的10.2%）回复了调查。只有37.3%的人正确回答了所有四个知识问题，其中普通/家庭医生为25.7%，内科医生为38.3%，心脏病专家为49.5%（p<0.001）。在评估高血压和确定治疗目标的态度方面，大多数受访者同意既定指南。然而，当被问及如何治疗无并发症的轻度高血压时，只有23%的人按照指南将选择限制在利尿剂和β受体阻滞剂。特别是心脏病专家比内科医生或普通/家庭医生更有可能选择其他药物类别，如血管紧张素转换酶抑制剂或钙通道阻滞剂。
我们的调查结果表明，必须继续在全国范围内开展工作，使医生了解日益复杂的高血压治疗手段，并说服他们根据一级预防的随机对照试验结果来开药。
