IMPACT OF NATIONAL CONSENSUS CONFERENCE O F CHOLESTEROL AND HYPERTENSION IN SPAIN

BACKGROUND: In May 1989 and June 1990, consensus conferences of treatm ent of hypertension and hypercholesterolemia respectively were held in Spain, at the General Division of Health Planning from the Ministry o f Health. The objective of this article is to assess the effect of suc h conferences of physicians' knowledge, attitudes and practices. SUBJE CTS AND METHODS: Cross-sectional telephone survey was carried out in p hysicians of general medicine, family practice, internal medicine and cardiology specialities. 807 physicians were selected, 347 family phys icians, 177 general practitioners, 156 cardiologists and 128 internist s. A questionnaire of 30 items was designed to obtain information abou t demographic and professional characteristics, knowledge of the conse nsus conferences and attitudes related to a case of an otherwise healt hy asymptomatic 48-years-old man. RESULTS: The response rate was 57% ( 463 physicians), and 60% of physicians had knowledge about the confere nces, being general practitioners the ones who had less knowledge of t he conferences. The items about recommendations of diet and pharmacolo gical treatment were properly answered (about 50% of the physicians an swered correctly). The mean of serum cholesterol when diet and drugs a re recommended was 232 mg/dl (SD 23) (6.01 mmol/l) and 260 mg/dl (SD 2 5) (6.7 mmol/l) respectively. The first-choice cholesterol lowering dr ugs were statines. A patient was considered as hypertensive it the mea n of systolic blood pressure was 149 mmHg (9.4) and the mean for diast olic blood pressure was 92 mmHg (3.8). The mean of diastolic blood pre ssure considered for drug treatment was 96.7 mmHg (SD 4.6). The first- choice antihypertensive drugs were angiotensin conversive enzime inhib itors. CONCLUSIONS: Diffusion of the conferences has been unequal, bei ng general practitioners less knowledgeable about the content of the c onferences. Although physicians know reasonably well the recommendatio ns about diet and drut treatments, the attitude in practice is more ag ressive than recommended. Globally, the knowledge of the contents of t he conferences was acceptable, although there were differences between specialties; however the effect on clinical practice is still low.