Cerrahpasa School of Medicine, Istanbul University, Turkey.
Eur J Prev Cardiol. 2013 Oct;20(5):786-92. doi: 10.1177/2047487312449590. Epub 2012 May 30.
The Supporting Hypertension Awareness and Research Europe-wide (SHARE) survey aimed to qualify the key challenges that physicians face when trying to get patients to recommended blood pressure (BP) goals.
The survey was open to physicians involved in the treatment of hypertension, was anonymous, and included 45 questions covering: physicians' demographic information, familiarity with BP treatment guidelines, views on the BP targets recommended by the 2007 European Society of Hypertension and European Society of Cardiology (ESH-ESC) guidelines, and perceptions on the proportion of 'challenging patients' in hypertension management (defined as patients not achieving the BP goal, where the BP goal is at least <140/90 mm Hg, and <130/80 mm Hg for patients with co-morbidities or high CV risk). Physicians significantly underestimated the proportions of their 'challenging patients' with hypertension compared with their perceptions of the proportions achieving 2007 ESH-ESC BP targets (p < 0.0001). The majority of cardiologists (75.5%) and general/family practitioners (GPs) (81.3%) as well as internists (59.3%) (p < 0.05 for cardiologists and GPs vs internists) felt that it was a challenge to get their patients to target BP, stating that only 43.2%, 57.4% and 38.2% of their patients, respectively, achieved these targets in practice (p < 0.05 for GPs vs cardiologists and internists).
Physicians may underestimate the proportion of 'challenging patients' with hypertension and there is a need to improve their BP control. Increasing physicians' awareness about the risks of uncontrolled BP and improving compliance are two possible ways to improve management of hypertension.
支持高血压认识和研究在全欧洲范围内(SHARE)的调查旨在确定医生在试图使患者达到推荐血压(BP)目标时面临的关键挑战。
该调查面向参与高血压治疗的医生开放,匿名进行,共包括 45 个问题,涵盖医生的人口统计学信息、对 BP 治疗指南的熟悉程度、对 2007 年欧洲高血压学会和欧洲心脏病学会(ESH-ESC)指南推荐的 BP 目标的看法,以及对高血压管理中“挑战性患者”比例的看法(定义为未达到 BP 目标的患者,其中 BP 目标至少为<140/90mmHg,伴有合并症或高心血管风险的患者为<130/80mmHg)。与医生对实现 2007 年 ESH-ESC BP 目标的比例的看法相比,医生明显低估了其高血压“挑战性患者”的比例(p<0.0001)。大多数心脏病专家(75.5%)和全科医生/家庭医生(81.3%)以及内科医生(59.3%)(心脏病专家和全科医生与内科医生相比,p<0.05)认为,让患者达到 BP 目标是一项挑战,他们分别表示,只有 43.2%、57.4%和 38.2%的患者在实践中达到了这些目标(全科医生与心脏病专家和内科医生相比,p<0.05)。
医生可能低估了高血压“挑战性患者”的比例,需要改善他们的 BP 控制。提高医生对未控制 BP 风险的认识并提高依从性是改善高血压管理的两种可能方法。