Physicians' attitudes to four common problems: hypertension, atrial fibrillation, transient ischaemic attacks, and angina pectoris.

A questionnaire was completed by 341 senior physicians on their attitudes to four common cardiovascular problems. Their replies showed that uncertainty about the end point for diastolic blood pressure still prevails and that their approach to the management of hypertension of differing severity in men and women of varying ages stems more from personal belief than from the results of clinical trials. Unless patients with atrial fibrillation also had mitral valve disease anticoagulation was not thought to be necessary, thereby making it ethically possible to carry out a trial of anticoagulants in stroke prevention on patients with atrial fibrillation but no valvular disease. The physicians' suggestions for very active management in transient ischaemic attacks extended beyond the evidence available to them, whereas their approach to the use of coronary arteriography closely reflected the results of clinical trials. These findings may indicate that recent cardiovascular trials that have provided definitive results have had more impact than earlier inadequate studies.