Whitfield M, Hughes A
Department of Social Medicine, University of Bristol, England.
J R Soc Med. 1997 Jan;90(1):12-5. doi: 10.1177/014107689709000105.
The views of 542 general practitioners (GPs) and 64 consultant physicians about the management of patients with hypertension in general practice were sought by postal questionnaire. 325 (60%) of the GPs and 45 (70%) of the consultant physicians completed the questionnaire. For a 40-year-old man with no other cardiovascular risk factors most general practitioners would intervene with drugs at blood pressure levels specified in published guidelines, whereas many local consultants and older GPs would consider drug treatment at lower levels. About 75% of GPs, compared with 87% of consultants, would suggest drug treatment in a woman of 70 years with a BP of 180/100 mmHg. Although consultants tended to expect GPs to order more tests when investigating a patient with hypertension than the GPs actually did, both GPs and consultants would order similar types of investigations apart from imaging. Consultants had different expectations about the frequency with which general practitioners should record patients' blood pressure and the GPs' ability to prevent cardiovascular events in hypertensive patients. Many older GPs and consultants seem to have unrealistic expectations of the value of treating patients with hypertension.
通过邮寄问卷调查的方式，征求了542名全科医生（GPs）和64名内科顾问医生对于高血压患者在全科医疗中管理方式的看法。325名（60%）全科医生和45名（70%）内科顾问医生完成了问卷。对于一名没有其他心血管危险因素的40岁男性，大多数全科医生会在已发表指南规定的血压水平时使用药物进行干预，而许多当地的顾问医生和年长的全科医生会考虑在更低的血压水平时进行药物治疗。在一名血压为180/100 mmHg的70岁女性中，约75%的全科医生会建议药物治疗，相比之下，顾问医生的这一比例为87%。尽管顾问医生倾向于期望全科医生在对高血压患者进行调查时比全科医生实际做的更多地安排检查，但除了影像学检查外，全科医生和顾问医生都会安排类似类型的检查。顾问医生对于全科医生记录患者血压的频率以及全科医生在高血压患者中预防心血管事件的能力有着不同的期望。许多年长的全科医生和顾问医生似乎对治疗高血压患者的价值有着不切实际的期望。
