Department of Medical Psychology and Consultation-Liaison Psychiatry, Georges Pompidou European Hospital, Assistance Publique-Hopitaux de Paris, Paris, France.
J Hypertens. 2010 Jun;28(6):1330-9.
Despite clear international guidelines, the achievement of blood pressure (BP) control is still disappointing.
To determine whether physicians' perception of hypertension, in general, is related to their patients' BP measures.
DUO-HTA is a French cross-sectional survey, which included a representative sample of 346 general practitioners, 209 cardiologists and 2014 hypertensive patients. Data were collected using two self-administered questionnaires filled out by the hypertensive patients and their physicians. A cluster analysis was performed on the responses given by the physicians, prior to the inclusion of their patients into the study, to 13 questions concerning their perception of hypertension. Physicians were divided into five groups, ranging from 'poorly motivated' to 'highly motivated' physicians, with regard to their perception of hypertension. More motivated physicians had a more confident and optimistic approach of hypertension, looked more empathetic and supportive towards patients and were characterized by higher rates of patients with controlled BP included into the study (range 32-42%, P=0.01 for trend). After adjusting for sociodemographic, clinical and psychological patient-related variables, separate analyses for the patients included into the survey by general practitioners or cardiologists found a significant decreasing gradient for SBP according to physicians' level of motivation (respectively, P=0.029 and P=0.021). Close results were observed in multivariate logistic regression analyses of uncontrolled hypertension.
These results underline the importance of physicians' perception of hypertension, in addition or concurrently to their compliance with international guidelines, for a successful management of hypertensive patients
尽管有明确的国际指南，但血压（BP）控制的实现仍然令人失望。
确定医生对高血压的总体看法是否与患者的 BP 测量值有关。
DUO-HTA 是一项法国的横断面调查，包括 346 名普通科医生、209 名心脏病专家和 2014 名高血压患者的代表性样本。使用高血压患者及其医生填写的两份自我管理问卷收集数据。在将患者纳入研究之前，对医生的回答进行聚类分析，涉及 13 个关于他们对高血压看法的问题。医生被分为五个组，从“动机较差”到“动机较高”的医生，根据他们对高血压的看法。更有动力的医生对高血压的态度更有信心和乐观，对患者更富有同情心和支持，并具有更高的研究中血压控制患者的比例（范围为 32-42%，P=0.01 趋势）。在校正了患者的社会人口统计学、临床和心理相关变量后，对普通科医生或心脏病专家纳入调查的患者进行单独分析，发现医生的动机水平与 SBP 呈显著下降梯度（分别为 P=0.029 和 P=0.021）。在对未控制高血压的多变量逻辑回归分析中观察到了类似的结果。
这些结果强调了医生对高血压的看法的重要性，除了或与国际指南的遵守性一起，对高血压患者的成功管理至关重要。
