Practitioners and nondrug treatment of hypertension, effects of participating in a survey

A nationwide survey in the Netherlands among 600 randomly sampled practitioners revealed that the advice (1) quit smoking, (2) reduce alcohol, (3) healthy diet, and (4) physical activities was only given by 76%, 26%, 44%, and 61% of the practitioners. To confirm these data, and to study the effects of the personal characteristics of the practitioners, and the effect of their participation in a survey. All general practitioners in the areas of Dordrecht in the Netherlands, with 350,000 inhabitants, were invited to participate. Self-administered questionnaires included questions about non-pharmaceutical treatment recommendations given, about blood pressure increasing factors including blood pressure increasing medicines, and healthy life style. After 1 year, the survey was repeated among the practitioners who completed the first one. The current survey produced a result largely similar to that of the nationwide survey. The combined results were as follows: among 281 practitioners a quit smoking advice was given by 82%, reduce alcohol advice by 47%, healthy diet advice by 51%, and physical activities advice by only 73% of the practitioners with 95% confidence intervals of, respectively, 75%-84%, 38%-49%, 41%-53%, and 64%-75%. Country physicians and older physicians were more active in giving nondrug treatments with P-values of <0.02 to <0.05. Increased blood pressure as a side effect of concomitant medications was virtually never addressed. After the survey, 26 practitioners (24.8%, P < 0.001) had started life style recommendations.