Hypertension management: a comparison of urban versus rural general practitioners in Western Australia.

1. We have conducted a survey of 75 rural and 75 urban randomly selected general practioners (GPs) in Western Australia to ascertain how closely current practice mirrors published Australian guidelines for the management of hypertension. 2. Fifty-one rural and 49 urban GPs completed the 19 item questionnaire. The two groups were well matched in terms of age and years in general practice. An assessment of the criteria utilized to diagnose hypertension revealed a tendency for much greater scatter in the cut points used to define systolic compared to diastolic hypertension, but no systematic difference between urban and rural GPs. 3. After an initial finding of mild hypertension the follow-up time to the next check-up was significantly longer for rural patients compared to urban patients (72 +/- 13 and 36 +/- 5 days respectively, P < 0.01). Urban GPs reviewed established hypertensive patients more commonly at 1-3 monthly intervals (89%) while rural GPs reviewed more commonly at 3-6 monthly intervals (86%). 4. In terms of target blood pressure (BP) for BP reduction, 67% rural compared to 83% urban GPs aimed for a systolic BP of < 140 mmHg (P = 0.06), while 95% of both groups aimed for diastolic BP < 90 mmHg. 5. The profile of first line antihypertensive agents most commonly used was also similar in both groups with 46% preferring angiotensin converting enzyme inhibitors, 18.5% diuretics, 18.5% beta blockers, 16% calcium entry blockers and 1% prazosin. 6. This study demonstrates a clear preference for the newer anti-hypertensive agents.(ABSTRACT TRUNCATED AT 250 WORDS)