Compliance with hypertension guidelines in general practice in Slovenia

Abstract

Compliance with hypertension guidelines in clinical practice is generally poor, but there was no data about compliance with any guidelines in general practice in Slovenia. Our aim was to find out whether general practitioners in Slovenia managed their hypertensive patients according to the national guidelines, based on 1999 WHO/ISH guideline recommendations. 42 family physicians registered all patients with the diagnosis of arterial hypertension among 300 consecutive regular office visits. We used data about blood pressure management from paper medical records. We collected data from 2752 patients with hypertension; the mean age was 64.1 years (SD = 12.4 years, from 21 to 97 years). All elements of the minimal diagnostic program in the last five years were performed in 23.8% of the patients. In 1809 (65.7%) patients, whose cardiovascular risk was estimated, the minimal diagnostic program was performed more frequently (p < 0.001). Non-pharmacological measures were performed in 1210 (47.0%) patients. 2649 (97.6%) patients had drug therapy in accordance with the guidelines. Follow-up in accordance with the guidelines was performed in 1492 (55.3%) patients. Only 256 (9.3%) patients were managed completely according to the guidelines and only 347 (15.5%) of study population reached the target values of blood pressure. The impact of hypertension guidelines on patients' management in everyday primary care appears marginal. More emphasis should be placed on the efficient implementation of the guidelines.