PHYSICIANS APPROACH TO THE MANAGEMENT OF HYPERTENSION IN A DEVELOPINGCOMMUNITY

General physicians' (GP) approach to the management of hypertension wa s assessed by a standard questionnaire. Each of the 42 physicians stud ied see about 42 patients in a clinic day. Over half do not usually me asure the blood pressure (BP) of all new patients. A third do not inve stigate before starting therapy. Over half commence drug therapy with less than three BP readings, while over two thirds do so from appropri ate BP levels. Over 70% employ sedatives in treatment (50% as the only initial therapy); 45% employ parenteral drugs from a diastolic BP of 110 mmHg. Over 40% do not educate their patients on the implications o f hypertension and the need for regular treatment and follow-up, but m ost give follow-up appointments. Patients are requested to stop therap y once BP is normalised by 25.9% of GPs. These practices were not sign ificantly influenced by years of experience or by being a GP in a teac hing hospital system (P > 0.1 and P > 0.5, respectively). The study su ggests that physician recognition and management of hypertension is st ill inadequate and this might in part be related to a general heavy pa tient load. In addition, continued medical education is essential for physicians for the purpose of improving our management skills.