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GPs 'ignoring guidelines on hypertension'

GPs are disregarding national guidelines on treating hypertension – and one in 10 actively disagrees with them – according to new research.

A study of hypertension management among 111 GPs found they did not initiate treatment at appropriate levels, did not intensify treatment aggressively enough and did not use drug therapies as recommended.

Pressures of workload, disagreement over the best way to manage hypertension and worries over excessive 'medicalisation' were all cited as reasons.

The study, carried out by researchers at the University of Aberdeen, also revealed a gulf between what GPs said they would do in response to treatment scenarios and what they actually did in practice.

Researchers sent questionnaires to GPs in the Grampian region of Scotland asking about usual practice in hypertension management.

One practice was selected and treatment of 168 patients was then audited using British Hypertension Society guidelines as the standard.

While GPs responding to the questionnaire claimed patchy adherence to BHS guidelines, 77 per cent of patients with sub-optimal blood pressure received no treatment in practice, according to results presented at the European Meeting on Hypertension in Paris last week.

GPs gave a number of reasons

for not treating sub-optimal blood pressure, including workload issues, worries about overtreating patients, cost and doubts about benefit versus risk.

Some 12 per cent of GPs said they never followed BHS guidelines and 9 per cent said they disagreed with them.

Lead researcher Dr Mary MacLeod, senior lecturer in the department of medicine and therapeutics, said: 'Changing doctors' behaviour is very difficult. You need a "drip-drip" approach.'

By Alisdair Stirling

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