Physician approach to the recognition and initial management of hypertension. Results of a statewide survey of Maryland physicians

Abstract

A representative sample of Maryland physicians in three practice settings (family/general, internal medicine, and specialty practice) participated in a survey designed to identify their attitudes toward patients with high blood pressure. Respondents recommended initial laboratory investigations more frequently and treatment at lower levels of blood pressure than was the case in a national physician survey performed in 1977. Family/general practitioners were the most cautious in respect to recommending antihypertensive drug therapy. They expressed greater enthusiasm, however, for nonpharmacologic treatment of hypertension and other cardiovascular risk factors. Physicians in each of the three practice settings expressed strong support for the use of diuretics as initial drug therapy in patients with mild hypertension. Impediments to long-term care were overwhelmingly believed to be patient- rather than physician-related.