Physicians’ opinions about the management of hypertension: changes in Finland between 1985 and 1992

Abstract

The successful management of hypertension requires an active involvement of physicians. We studied trends in Finnish physicians’ opinions about the management of hypertension between 1985 and 1992. The response rates in these two random samples of physicians were 68% and 56%, respectively. Physicians who reported regularly treating hypertensive patients were included in our analyses (n₁ = 319, n₂ = 470). Fifty per cent of physicians used diastolic blood pressure of 100 mm Hg as a criterion for starting drug treatment and a goal blood pressure of 90 mm Hg was reported by 60% of physicians. Both levels decreased from 1985 to 1992. The variation in both of these blood pressure levels as reported by the physicians were wide both in 1985 and 1992. The activity in promoting non-pharmacological measures such as exercise and restriction of fat intake improved during this time period. The choice of drugs for anti-hypertensive therapy changed drastically from 1985 to 1992. For younger patients ACE inhibitors became the drug of choice and for older patients Ca-blockers gained popularity from diuretics. A similar shift can also be seen in the sales statistics. Whether this increased activity in starting drug therapy and using new drugs will improve the outcome of treatment remains to be seen.