Intended for healthcare professionals


Patients’ concepts of hypertension

BMJ 2012; 345 doi: (Published 16 July 2012) Cite this as: BMJ 2012;345:e4688
  1. Attila Altiner, professor of general practice
  1. 1Department of General Practice, University Medicine Rostock, Rostock 18055, Germany
  1. altiner{at}

New insights support the need for more shared decision making independent of cultural background

The improvement in medical care through educational interventions is a complex undertaking and requires a thorough exploration of existing beliefs and attitudes. It has been assumed that concepts of disease are closely related to the prevailing local medicosocial context of doctors and patients, and that therefore they differ between different ethnic and cultural groups. In the linked systematic review of qualitative research on lay perspectives on hypertension (doi:10.1136/bmj.e3953), Marshall and colleagues challenge this widely accepted view.1

Smaller studies have shown some unexpected similarities between ethnic groups in their views and expectations about medical conditions.2 However, this review shows a remarkable consistency in patients’ attitudes and beliefs about hypertension among different ethnic groups in Africa, Asia, Europe, and North and South America.

When looking for a possible explanation of this consistency we have to take into account the fact that hypertension is a relatively new disease introduced by Western practitioners. The association between blood pressure values …

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