BLOOD PRESSURE MEASUREMENT AND MONITORING BY INTERNAL MEDICINE SPECIALISTS IN GERMANY IN VIEW OF THE SPRINT TRIAL

Abstract

Objective: There are continuous discussions about the optimal target blood pressure values, not least due to the publication of the SPRINT study, where unattended ambulatory office blood pressure (AOBP) was used for blood pressure (BP) measurement. The aim of the following online survey was to examine how BP measurement and the management of hypertensive patients are handled in everyday practice by internal medicine specialists in Germany and to compare it with the current guidelines. Design and method: An online questionnaire with ten questions concerning methods of BP measurement was sent to 15,884 internal medicine specialists as an email via the mailing list of the German Society of Internal Medicine (DGIM). Of these, 731 took part in the survey, which corresponds to a response rate of 4 %. The statistical evaluation was carried out with MS Excel. Results: The standard auscultatory measurement with an aneroid manometer is the leading method used by 44 % and in 95 % of the cases, it is measured in the presence of medical staff, i.e., attended. With 53 %, more than half of the respondents only take one measurement. A group of 36 % take two or more measurements. Of these, the largest percentage with 28 % takes the last value, closely followed by 26 %, who use the average value. The first or lowest value is each used by 17 %, while a minority of 12 % use the highest value. A majority of two-thirds measures without any time reference to taking medication (66 %). Ambulatory and Home BP are used by the majority for therapy control, according to the survey (fig.) Conclusions: The guidelines are not implemented correctly in many places and the approach to managing hypertension patients varies considerably. Possible reasons for this might be a lack of time in everyday practice and not always specifically formulated specifications in the recommendations of the professional associations, which leads to ambiguities. Measurement using unattended AOBP is rarely used in Germany. To be able to transfer the results from SPRINT, this measurement method would first have to be established.