How do you explain the causes of hypertension to patients?
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Cardiology
How do you explain the causes of hypertension to patients?
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Recent BMJ research has found that "Non-adherence to hypertension treatment often resulted from patients’ understanding of the causes and effects of hypertension; particularly relying on the pre
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Forums » Open clinical » Cardiology » How do you explain the causes of hypertension to patients?
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How do you explain the causes of hypertension to patients?
posted at 23/7/2012 10:57 AM BST
on bmj.com
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*Moderator*
Posts: 1436
First: 7/4/2011 Last: 17/5/2013 |
Recent BMJ research has found that "Non-adherence to hypertension treatment often resulted from patients’ understanding of the causes and effects of hypertension; particularly relying on the presence of stress or symptoms to determine if blood pressure was raised." This study also seems to dispel the idea that was circulating that there are cultural differences why patients do not adhere, and that culturally specific education for indvidual ethnic groups may not be justified. The research concludes that "To improve adherence, clinicians and educational interventions must better understand and engage with patients’ ideas about causality, experiences of symptoms, and concerns about drug side effects." http://www.bmj.com/content/345/bmj.e3953 How do you explain the causes of hypertension? Are there any common misconceptions? Do you see cultural differences at all? |
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Re: How do you explain the causes of hypertension to patients?
posted at 23/7/2012 11:18 AM BST
on bmj.com
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Posts: 873
First: 17/6/2011 Last: 17/5/2013 |
This has been a major focus of attention recently - Mike Knapton wrote a letter in the BMA news section this week about the work the British Heart Foundation are doing to improve understanding of conditions and hence concordance with treatment. By chance I was also at a meeting on Friday about the costs of medicine prescribed and not taken to the health system. My approach to this in hypertension is not to focus on the causes but to explain what might be achieved for future health and wellbeing but perhaps I should reconsider this? I'm interested to know who explains causes of hypertension and what you say. sadian |
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Re: How do you explain the causes of hypertension to patients?
posted at 23/7/2012 2:55 PM BST
on bmj.com
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Posts: 624
First: 13/4/2011 Last: 15/5/2013 |
Hello Mathew and sadian: That´s an interesting article. I talk a lot to them about Healthy Lifestyle habits, and the bad things that come along with stress. The medications only come up by the end of the consultation when I emphasise that they should take the medications every single day of their lifes. I TRY NOT TO USE MANY MEDICATIONS AND I PRESCRIBE ONLY GENERIC DRUGS, SO THEY WILL NOT HAVE FINANCIAL PRESSURES OVER THEIR TREATMENT. TALKING ABOUT DRUG SIDE-EFFECTS AND SHARING THE DECISION WITH PATIENTS BUILDS FURTHER RAPPORT WITH THEM, AND I THINK HELPS ADHERENCE TO TREATMENT. No, I do not see cultural differences to influence treatment. Lower socio-economic and educational levels I think can decrease adherence to treatment. All Best, Joey |
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Re: How do you explain the causes of hypertension to patients?
posted at 28/7/2012 9:46 AM BST
on bmj.com
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Posts: 2
First: 28/7/2012 Last: 28/7/2012 |
thanks for wonderful discussion. i shall ask all my pediatric patient , if their is history of hypertension in the parents/ family. now a days teens are facing diffucult time as bacause of parents life style. i feel , it is good to tell about these life style diseases to teens., and to clear their idea of games , study , happiness , walking , work sharing and caring ..lot of disiplane in life may not help every time. i am sure it is a preventable disease , if taken into account in teens |
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Re: How do you explain the causes of hypertension to patients?
posted at 13/8/2012 5:33 AM BST
on bmj.com
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Posts: 1
First: 13/8/2012 Last: 13/8/2012 |
In Response to Re: How do you explain the causes of hypertension to patients?: Hi Joey R Thanks for this - what do you say causes hypertension? sadian Posted by sadian Being obesed is one cause of hypertension or highblood pressure. Stress can trigger also. There are only a few know that they have hypertension. There are many treatment strategies for this but it is better we can prevent it. |
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Re: How do you explain the causes of hypertension to patients?
posted at 13/8/2012 7:53 AM BST
on bmj.com
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Posts: 2947
First: 10/3/2009 Last: 29/4/2013 |
I don't know the commonest cause of hypertension so how can I. Could someone give me the Ladybird Book of Essential Hypertension simplified version. I am not sure why it is essential as it does not seem at all essential although possibly idiopathic. Why is medicine so full of bull? |
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Re: How do you explain the causes of hypertension to patients?
posted at 13/8/2012 5:08 PM BST
on bmj.com
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Posts: 873
First: 17/6/2011 Last: 17/5/2013 |
I agree with you Odysseus - there is nothing essential about hypertension. I personally don't spend much time on the causes but I do spend a lot of time on treatment and in particular lifestyle factors - whether anyone pays any attention is another matter! plus I agree with the fact that we need to pay more attention to our teenagers- I recently saw a 30 year old with a STEMI where there is no obvioud underlying cause but there were a lot of adverse life style factors sadian |
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Re: How do you explain the causes of hypertension to patients?
posted at 13/9/2012 2:21 PM BST
on bmj.com
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Posts: 92
First: 20/3/2012 Last: 25/10/2012 |
I am a staff nurse so my idea of an explanation to a patient is usually wildly different to the clinicians. Certainly, where I currently work, despite a comprehensive Cardiac service and plenty of Cardiologists, it is very rarely discussed with patients. Admittedly, I do not spend as much time as I used to explaining to patients due to time constraints. In my previous job, there were less constraints and I had more time with patients. once a patient asked me what Hypertension was, how it was caused etc etc and I spent the best part of an hour explaining the ins and outs of Hypertension with them. At the end of it they were delighted as they knew most of what there was to know about Hypertension as I had managed to explain it all in a way that they understood (by the end of it, I had about 4 patients listening intenly to what I was saying). I guess it really depends on my assessment of what the patient is likely to understand..some patients can grasp much more than others. As for cultural differences, I had never considered it before but, thinking about it now, it does seem to me that those of other cultures (Africa, Eastern, Indian etc) do seem to pay less attention which is a shame given that they need the most knowledge due to the higher occurence rates, particularly in West African Men. It is also down to each individual health person as to how comfortable they are explaining things to patients...personally, that is the part of my job that I excel at and is my best asset but it is rare to find doctors who have that same skillset.....or just feel able to or even want to. Comparing my 2 most recent jobs in cardiology shows a marked contrast between clinicians and even nurses. In my previous job (at a major Regional Centre), both doctors and nurses spent plenty of time explaining things to patients and even the Consultants were quite happy to spend time with the patiens. In contrast, in my current job (at a local DGH with 6 Cardiology Consultants), the Consultants generally have absolutely no interest in the patients not on CCU or in the Cath Lab and very rarely step foot on the ward, let alone spend time with patients; Registrars do spend time with patients but the patients don't usually feel that they grasped what was said and even most of the nurses don't spend the time with the patients (partly time pressure, partly no interest). For me, talking about causes of things such as Hypertension is just as vital as the physical care but too many patients leave hospital with poor knowledge of their condition. My fear is that it will get worse as both junior doctors and staff nurses are put under more and more pressure. Cardiac Rehab explain things to a point but not in really enough detail. Not sure what the answer is that could be applied in this climate. personally, I will just continue to educate my patients as much as possible whether they want me to or not!
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Re: How do you explain the causes of hypertension to patients?
posted at 13/9/2012 5:51 PM BST
on bmj.com
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Posts: 3037
First: 27/3/2012 Last: 18/5/2013 |
Although apparently easy, it would be difficult to explain the causes of hypertension to the patient. I do agree with respected Odysseus about the misnomer 'essential' hypertension. Essential hypertension accounts for about 95% of cases. Secondary hypertension is the term for high blood pressure with a known direct cause, such as kidney disease, tumors, or birth control pills. Though the exact causes of hypertension are usually unknown, there are several factors that have been highly associated with the condition. These include: Smoking,Obesity or being overweigh, Diabetes, Sedentary lifestyle, Lack of physical activity, High levels of salt intake (sodium sensitivity, Insufficient calcium, potassium, and magnesium consumptio,Vitamin D deficiency, High levels of alcohol consumption, Stress, Aging, Medicines such as birth control pills, Genetics and a family history of hypertension, Chronic kidney disease, Adrenal and thyroid problems or tumors, etc. There is also some established racial/cultural relationship. |
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