Treatment of High Blood Pressure in Germany

Abstract

The reunification of Germany has made it possible to compare the health care in two independently developed social structures. The prevalence of hypertension was considerably greater in East German men and women, compared with West German men and women, although salt intake was lower in East Germany than in West Germany. Cardiovascular mortality was correspondingly greater. A centralized public health effort was used in East Germany, whereas in West Germany, the activities were decentralized and to a large extent dependent on private philanthropists. In the last two decades, cardiovascular mortality declined in West German men and women, whereas the same was not true for East German men and women. Hypertension incidence, awareness, treatment, and control have improved slightly in Germany, but not enough to explain the improved morbidity figures. Twenty percent of men and women remain unaware of their hypertension, 40% are aware but not treated, and only half are aware and controlled. Complacency is unjustified in Germany and much needs to be done. Am J Hypertens 1998; 11:750 -753

Unmet needs in hypertension: Challenges and opportunities

“…According to the Monitoring Trends and Determinants in Cardiovascular Disease (MONICA) project [31] in France, 52% of hypertensive men and 70% of hypertensive women with blood pressure of 160/95 mm Hg or greater were aware of their condition. These rates are significantly lower than rates reported by the MONICA project [32] in Germany, where approximately 80% of hypertensive men and women with blood pressure of 160/95 mm Hg or greater received a diagnosis of hypertension. In addition, the 1994 Health Survey for England [33] estimated the awareness of hypertension in the United Kingdom by using both 160 /95 m m Hg and 14 0/90 mm Hg as definitions.…”

Antihypertensive drug utilization at health centres in a district of Istanbul

“…In fact, lack of compliance is a common cause of inadequate control of hypertension [1,2,8]. Unsatisfactory treatment of hypertension has been reported in epidemiologic studies from different countries [8][9][10]. Irrational use of antihypertensive drugs depends on several reasons such as the lack of proper training of physicians and pharmacists as well as patients' attitudes.…”

“…Moreover, irrational use of drugs differs from country to country. Developed countries have taken some measures to solve these problems, but greater effort at national and international levels is needed for the developing countries [10][11][12][13][14]. Undergraduate medical education focused on rational pharmacotherapy process is one of the solutions offered [15].…”

Why Are We Doing So Badly with the Control of Hypertension? Poor Compliance Is Only Part of the Story

“…What is going on? We in the United States are not alone in this respect: statistics from numerous other countries show that control rates are, if anything, worse overseas: In France and Germany, which by some accounts have health care systems in many ways superior to ours, the rates are even lower 2,3 …”