Management of Hypertension.
The British Hypertension Society gives admirably
authoritative Guidelines (1) for the management of hypertension, but
following them will have enormous impact on General Practice workload.
Our practice of 6,800 patients has followed the Society's guidelines
for five years now,but has managed to detect and treat only some 5% of our
population. Another 5% is yet to be detected.
Counting only those already detected, about half fit into the
Society's "high risk" categories needing 3-monthly review, the other half
requiring 6-monthly review. This makes some 700 appointments per year in
clinics - a session a week of doctor/nurse practitioner time; a whole day
a week should we find the undetected cases. Adding this to current
committments in diabetes, asthma, vaccinations, child surveillance and so
on inevitably means less time will be available forpatient-led concerns.
Patients do not want this.
More practitioners - doctors and nurses - are required to make the
guidelines effective in reducing hypertension-related morbidity.
Tom Black FRCGP
Colum Farrelly FRCGP
Mary Cartin BSc.
Abbey Medical, Derry, N. Ireland.
(1) Lawrence E, Ramsey et al, British Hypertension Society
guidelines for hypertension management 1999. Summary. BMJ 1999 319: 630-
Competing interests: No competing interests