What General Practitioners Say About High Blood Pressure Prevention, Screening and Treatment in France in 2019

General practitioners interviewed about high blood pressure treatment in France say that the lack of time for preventive care during appointments as well as incomplete knowledge and misunderstanding among patients about the illness hinders efforts to control of high blood pressure. Source: Bulletin Epidémiologique Hebdomadaire – Santé Publique France – February 25, 2020

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High blood pressure is the number one chronic illness in the world. In France, an estimated 30% of the adult population has high blood pressure. It is one of the leading cardiovascular risk factors and the main risk factor for stroke. This illness can be prevented by adopting healthy behaviors like getting regular physical activity, eating a balanced diet and controlling your weight to counter this silent killer. General practitioners are on the front lines of screening and treating high blood pressure. This study gathered the opinions and views of 753 general practitioners who answered a survey on high blood pressure treatment in 2019. Preventing High Blood Pressure
A majority of general practitioners (83%) say they’re highly involved in hypertension prevention. Yet, only 39% of doctors say they’re highly involved in nutritional prevention (32% of men and 51% of women), while 45% focus on excess weight (43% of men and 50% of women) and 48% on sedentary lifestyles (47% of men and 51% of women). The majority of doctors (84%) mentioned the lack of time and 29% highlighted the lack of prevention tools as barriers to setting up a preventive approach during appointments. Treating High Blood Pressure
When doctors diagnose high blood pressure, nearly all of them (96%) suggest lifestyle changes to their patients along with medication, if necessary. Ninety-three percent of doctors report that their patients have concerns when they are prescribed medication for high blood pressure, such as wondering why they have to take medication for the rest of their lives, not feeling sick, misunderstanding the risks of high blood pressure or intolerance for blood pressure medications. Among the reasons that may explain poor adherence to blood pressure medication, doctors cite the following, in decreasing order of frequency:
Patients have difficulty accepting the disease or get tired of taking medication. They don’t have any symptoms of high blood pressure. They have incorrect information about the disease. Or they have drug intolerance. Finally, a third of doctors surveyed cited controversies surrounding various cardiovascular therapies as a possible explanation for poor adherence. To facilitate treatment of their patients with hypertension, 45% of doctors surveyed say they want better enterprise software and 29% want to collaborate with other clinical staff. Doctors also indicated a desire for more information, training and medical literature. In summary, this study highlighted the difficulty of providing the information and therapeutic education essential for treating patients with hypertension during a general medical consultation. It also showed that setting up dedicated consultations covered by insurance and providing access to other health professionals through multidisciplinary teams could improve prevention efforts for these patients. Finally, some doctors mentioned the need for training and information tools to improve high blood pressure prevention and treatment. Grave G, Gautier A, Gane J, Gabet A, Lacoin F, Olié V. Prévention, dépistage et prise en charge de l’HTA en France, le point de vue des médecins généralistes, France, 2019. Bull Epidémiol Hebd. 2020;(5):115-23. http://beh.santepubliquefrance.fr/beh/2020/5/2020_5_3.html




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