Mancusi Costantino, de Simone Giovanni, Asteggiano Riccardo, Richter Dimitri, Williams Bryan, Ferrini Marc
Hypertension Research Center, Federico II University Hospital, Naples, Italy.
School of Medicine, University of Insubria, ASST-Settelaghi, Varese, Italy.
Eur Heart J Open. 2021 Aug 7;1(2):oeab013. doi: 10.1093/ehjopen/oeab013. eCollection 2021 Sep.
To explore the management of hypertensive patients by general cardiologists a few months after the European Society of Cardiology (ESC)-European Society of Hypertension (ESH) Guidelines publication.
A survey based on a 26-point questionnaire was sent to ∼69 000 worldwide ESC members, a few months after the ESC-ESH Guidelines publication. A total of 1458 responses were collected via a web-based form. Among them, 68% were men, 48% were below 45 years old, and 60% were from Europe. Current guidelines have been read, at least partially, by 92.8%. Measurement of blood pressure (BP) is mostly done using the auscultatory method (58.8%) while unattended BP is rarely performed. Different bladder cuffs are not available for different arm circumferences for 27% of responders. Routine workup in hypertensive patients includes more often 12 leads ECG (97.7%) and echocardiography (79.6%). Only 30.9% of responders systematically assess the cardiovascular risk by the SCORE system and orthostatic hypotension is systematically researched by only 39.1%. Respondents consider that BP target of 140/90 mmHg is achievable in 60-80% of patients and 130/80 mmHg in 40-60%. Guidelines are considered too tight to be achievable by 15.6%, while 77.4% consider they are exactly right. Low patient's compliance, awareness of hypertension (HT) risk, and, at a lower degree, physician inertia, represent the main treatment challenges in reaching BP goals to most respondents, while treatment effectiveness is not in question. The present survey demonstrates specific gaps in HT management that need attention in clinical practice.
探讨在欧洲心脏病学会（ESC）-欧洲高血压学会（ESH）指南发布数月后，普通心脏病专家对高血压患者的管理情况。
在ESC-ESH指南发布数月后，向全球约69000名ESC成员发送了一份基于26个问题的调查问卷。通过网络表格共收集到1458份回复。其中，68%为男性，48%年龄在45岁以下，60%来自欧洲。92.8%的人至少部分阅读了当前指南。血压（BP）测量大多采用听诊法（58.8%），而无人值守血压测量很少进行。27%的受访者没有针对不同臂围配备不同的气囊袖带。高血压患者的常规检查中，12导联心电图（97.7%）和超声心动图（79.6%）更为常用。只有30.9%的受访者通过SCORE系统系统评估心血管风险，只有39.1%的人系统研究体位性低血压。受访者认为，60 - 80%的患者可实现血压目标为140/90 mmHg，40 - 60%的患者可实现130/80 mmHg。15.6%的人认为指南过于严格难以实现，而77.4%的人认为恰到好处。对大多数受访者而言，患者依从性低、高血压（HT）风险意识以及较低程度上的医生惰性是实现血压目标的主要治疗挑战，而治疗效果不存在问题。本次调查揭示了高血压管理中存在的特定差距，在临床实践中需要予以关注。
