General practitioners ignore high normal blood pressure.

Area of Science:

• Cardiology
• General Practice
• Public Health

Background:

• Accurate diagnosis of elevated blood pressure is crucial for cardiovascular risk management.
• Primary care physicians play a vital role in initial hypertension detection and management.
• Assessing diagnostic capabilities in primary care settings is essential for improving patient outcomes.

Purpose of the Study:

• To evaluate the diagnostic accuracy of Polish primary care physicians regarding elevated blood pressure.
• To determine how cardiovascular risk factors, including diabetes mellitus, influence blood pressure diagnosis.
• To investigate the correlation between physician age and diagnostic errors in blood pressure assessment.

Main Methods:

• A survey was conducted using a questionnaire with eight distinct clinical cases.
• The cases varied in blood pressure levels (high normal vs. grade 2 hypertension), presence of risk factors, and diabetes mellitus status.
• A stratified sample of primary health care physicians in Poland participated, achieving a 65% response rate.

Main Results:

• Overall correct diagnosis of blood pressure levels was achieved in only 54.8% of responses.
• Incorrect diagnosis rates for high normal blood pressure were high, ranging from 64.0% to 84.0%, significantly increasing with diabetes.
• Grade 2 hypertension was diagnosed incorrectly in 8.8% to 20.8% of cases.
• Older physicians demonstrated a higher frequency of diagnostic errors (r = 0.38, p<0.001).

Conclusions:

• A significant proportion of Polish primary care physicians struggle to correctly diagnose elevated blood pressure, particularly high normal levels.
• The presence of diabetes mellitus substantially increases the likelihood of misdiagnosing high normal blood pressure.
• Physician age is a significant factor associated with diagnostic inaccuracies in blood pressure assessment.