Management of arterial hypertension: Transfer from clinical guidelines into daily practice – Results of a survey in German practitioners offices

The principal objective of clinical guidelines is to improve the quality of medical care. However, standardized evaluation of the adoption into daily practice is missing. The aim of our study was to investigate the implementation of guideline recommendations on the management of arterial hypertension (AH) in German general practitioner’s (GPs) offices.

A questionnaire focusing on the implementation of the German guidelines for the management of AH was developed and prospectively rolled out in 3.200 GPs and field‑based specialists in internal medicine in Germany. Data were interpreted in an explorative way.

Data from 689 German physicians that participated in the survey were analyzed. Effectiveness of lifestyle changes in the management of AH was rated as very high or high in 36.6%. When lifestyle changes only will not normalize blood pressure (BP), medical treatment will be initiated after 2–6 months by majority of physicians. Decision for mono‑ or combination therapy was driven by BP and patient’s risk profile. Choice for a specific antihypertensive substance was based on the recommendations of scientific guidelines in the majority of GPs.

Medication treatment algorithms recommended in 2015 by German guidelines are well accepted by GPs. Lifestyle changes are voted by only slightly more than one‑third as a reasonable tool for the management of AH in the setting of the medical office. This might reflect a lack of certified medical education regarding this topic. Our study was not designed to register the time from publication of guidelines to practical implementation.