ARTERIAL HYPERTENSION MANAGEMENT TRENDS IN PAKISTAN; CROSS-SECTIONAL OBSERVATIONAL STUDY OF A SAMPLE OF PAKISTANI DOCTORS

Abstract

Abstract Objective: To look at the practice trends regarding Hypertension in Pakistani doctors and to find out the weak links in our diagnosis, management, care and followup. Design and method: Study Setting: The study was conducted on 600 doctors practicing in different cities of Pakistan. These doctors came from all professional spheres, Fresh Graduates, Post graduate trainee, Consultants (of all ranks) and Family Physicians etc. Study Design: Observational cross-sectional. Study Population and Sampling Technique: We used cluster random sampling method to collect data. Results: Only 146 (24.3%) were following the guidelines while 235 (39.2%) were measuring it too early or 148 (24.6%) were measuring too late. Seventy one (11.8%) of the surveyed individual did not respond to this question. According to latest guidelines, - A heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, that facilitates achieving a desirable weight is recommended for adults with elevated BP or hypertension. Sodium reduction is recommended for adults with elevated BP or hypertension. Only 3.7% doctors talked about DASH diet in survey questionnaire, and not all the doctors are advising salt reduction to hypertensive patients comprising only 70.2%. Only 2.5% doctors are advising to increase water intake and even alarming is that advising smoking cessation to hypertensive patients is talked about by only 4.3% of doctors. Desired BP control is a difficult task even in developed countries. In Pakistan less than 3 % have adequate control Table 3 shows the responses to our inquiry - Grade each of the following separately which is in your opinion the most likely cause of inadequate BP control; from 1–5 (1 being somewhat common cause, and 5 being leas t common cause). The response shows the wide range of issues that we have regarding controlling the blood pressure. Conclusions: Issues in our society are multi-factorial. Need to emphasize to the physicians the importance of Continuance Medical Education and improving your practice skills. Also need to reach out to patients by all current mediums so they may be able to better understand the risks a person is under when he/she develop hypertension.