NONPHARMACOLOGICAL MANAGEMENT OF HYPERTENSION - RESULTS FROM INTERVIEWS WITH 100 GENERAL-PRACTITIONERS

Objective To describe the type and level of non-pharmacological manage ment offered by general practitioners for essential hypertension. Desi gn An open-ended interviewer-administered survey using a standard case of a 60-year-old man with essential hypertension. Seventy interviews were conducted face-to-face and 30 by telephone. Setting Auckland gene ral practices. Subjects A random sample of 100 Auckland general practi tioners. Main outcome measures Aspects of the medical histories of pat ients, physical examination, laboratory testing and treatment relevant to non-pharmacological management. Results There was an 84% response rate. Most general practitioners reported offering non-pharmacological management at the first consultation before prescribing medication. H owever, few offered detailed programmes. Dietary therapy, restriction of alcohol consumption and exercise were suggested by most general pra ctitioners. Restriction of sodium intake and behavioural therapy were less popular non-pharmacological interventions. The median number of v isits of patients to a general practitioner before drugs were prescrib ed was five, which is in keeping with guidelines. The median number of days from the first visit to prescription of drug therapy was 42 (ran ge 2-341). The clinical advice given by the majority of participants w as consistent with current guidelines on the treatment of hypertension but the range of advice given was wide. Conclusions The results sugge st that general practitioners are aware of non-pharmacological interve ntions for the management of hypertension. They report making routine use of non-pharmacological therapies for blood pressure reduction and other health benefits early in the clinical process before considering pharmacological therapy. These non-pharmacological therapies are not delivered with well-defined and detailed programmes.