HYPOTENSION - DOES IT MAKE SENSE IN FAMILY-PRACTICE

In general practice many diagnostic labels are used that are related t o cultural background rather than a scientific basis. To estimate the use of diagnoses like 'hypotension' and depression, a cross-sectional survey in German and British GPs' surgeries was performed. Prevalence of related symptoms, socio-demographic and medical data were recorded as well as actual and previous blood pressure levels. In German genera l practice, where 'hypotension' is an established entity, 17% of all p atients attending were reported as hypotensive either by their doctor or by themselves. The proportion was twice as high among women than am ong men. It was more common among the young. One-quarter of these pati ents were on medication to raise their blood pressure. Actual and prev ious blood pressure levels failed to explain the occurrence of symptom s like tiredness, dizziness, headache etc. Demographic characteristics of patients diagnosed as depressed were similar in both countries. Pr esumably for economic reasons there is a tendency for German GPs to us e more diagnostic labels of any kind. It was concluded that diagnostic labels attached to vague but frequently presented symptoms vary consi derably between countries. They often lack a physiologic rationale. Ne vertheless they often support the tendency to somatize common problems .