The role of alcohol in the management of hypertension in patients in European primary health care practices – a survey in the largest European Union countries

Abstract

BackgroundEven though addressing lifestyle problems is a major recommendation in most guidelines for the treatment of hypertension (HTN), alcohol problems are not routinely addressed in the management of hypertension in primary health care.MethodsInternet based survey of 3081 primary care physicians, recruited via the mailing lists of associations for general practitioners (GPs) in France, Germany, Italy, Spain and the UK. Clinical practice, attitudes, knowledge, education and training were assessed. Logistic regression to predict screening, brief intervention and treatment for alcohol dependence in the management of hypertension were assessed.ResultsOverall, about one third of the interviewed GPs reported sufficient screening in cases with HTN (34.0 %, 95 % confidence interval (CI):32.1–35.8 %). One out of five GPs screened and delivered brief interventions in HTN patients with hazardous consumption (22.2 %, 95 % CI: 20.6–23.8 %) and about one in 13 GPs provided treatment for HTN patients with alcohol dependence other than advice or brief intervention (7.8 %, 95 % CI: 6.8–8.9 %). Post-graduate training and belief in their effectiveness predicted interventions. There were marked differences between countries.ConclusionsWhile current interventions were overall low, marked differences between countries indicate that current practices could be improved. Education and post-graduate training seems to be key in improving clinical practice of including interventions for problematic alcohol consumption and alcohol dependence in primary health care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0529-5) contains supplementary material, which is available to authorized users.

Sex‐Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta‐Analysis of Cohort Studies

“…Unfortunately, despite some guidelines recommending such an approach, it is rarely followed in clinical practice (for the example of the 6 largest European Union countries72). Efforts should be made to change clinical practice, given that alcohol‐induced hypertension is both preventable and reversible,10, 59 and there are effective and cost‐effective interventions to reduce alcohol consumption level in primary care 73, 74.…”

Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union

“…In preparation for the conference, a number of national meetings on its topic were held in Belgium [ 10 ], Finland [ 11 ], Germany [ 12 ], Spain [ 13 ], and the UK [ 14 ], where presentations of systematic reviews and meta-analyses on causality and the relationship between drinking and BP (see below for a summary) and of systematic reviews on the effects of alcohol intervention on BP (see below for a summary) were held. Further, modelling of the potential impact of primary care interventions on alcohol (technical details on the modelling are listed in Appendix 2, following the stipulations of the GATHER statement [ 15 ]) was performed and the results from a survey among primary care physicians on practices concerning alcohol screening and interventions in the management of hypertension [ 16 ] were presented. Finally, draft recommendations, prepared on the basis of the abovementioned national meetings, were put forward.…”

Perbandingan Ketebalan Retina Sentral Pasien Hipertensi Esensial tanpa Penurunan Visus Dibanding Orang Normal

“…Prevalensi ini berada di angka 13,2% dari keseluruhan penduduk, yang jauh berada di atas rerata nasional yang berada pada 8,4%. 14 Obesitas, 15,16 minum minuman beralkohol secara berlebihan, 17,18 dan merokok 19,20 diketahui merupakan faktor risiko terjadinya hipertensi. Provinsi Sulawesi Utara menduduki posisi pertama nasional untuk obesitas yang mencapai 30,2% dari keseluruhan penduduk dibanding rerata nasional yang mencapai 21,8%.…”