Moderation of alcohol consumption as a recommendation in European hypertension management guidelines: a survey on awareness, screening and implementation among European physicians

Abstract

ObjectivesModeration of alcohol consumption is included as a class I, level of evidence A recommendation in the current European guidelines for the management of hypertension. We investigated its awareness and self-reported implementation among European physicians across different specialties and workplaces.Design and settingA cross-sectional survey study conducted in two annual German meetings (German Society of Cardiology and the German Society of Internal Medicine) and two annual European meetings (European Society of Hypertension and European Society Cardiology) in 2015.Participants1064 physicians attending the European meetings were interviewed including 52.1% cardiologists, 29.2% internists and 8.8% general practitioners.Main outcome measuresPhysician screening of alcohol consumption, awareness and self-implementation of the recommendation of the current European guidelines about moderation of alcohol consumption for the management of hypertension.ResultsOverall, 81.9% of physicians reported to generally quantify alcohol consumption in patients with hypertension. However, only 28.6% and 14.5% of participants reported screening alcohol consumption in their patients with newly detected or treatment-resistant hypertension. Physicians recommended a maximum alcohol intake of 13.1±11.7 g/day for women (95% CI 12.3 to 13.8) and 19.9±15.6 g/day for men (95% CI 18.8 to 20.9). In case of moderate to high alcohol consumption, 10.3% would manage only hypertension without addressing alcohol consumption, while 3.7% of the physicians would do so in case of alcohol dependence (p<0.001).ConclusionsThe average amount of alcohol intake per day recommended by European physicians in this survey was in agreement with the guidelines. The low number of physicians that screen for alcohol consumption in patients with newly detected and with treatment-resistant hypertension indicates an important deficit in the management of hypertension.

Underuse of lifestyle recommendations in hypertension management in France: The Esteban study

“…36 , 37 In contrast, the proportion of patients receiving lifestyle recommendations were higher in other European studies. 36 , 37 These differences may be accounted for by possible memory bias in our study sample, or more probably by the simple fact that French doctors prescribe lifestyle recommendations less than their counterparts in other European countries. The French society of HTN recommended at least 30 min for a medical visit of a newly diagnosed patient with HTN in its 2013 guidelines.…”

Prevalence and characteristics of hazardous and harmful drinkers receiving general practitioners’ brief advice on and support with alcohol consumption in Germany: results of a population survey

“…It is therefore important to also assess the GPs’ view on the topic, including in-depth information on barriers to the implementation of the treatment guideline recommendations in their daily practice. Previous surveys among GPs, however, usually only assessed how often, in general, GPs screen for alcohol or provide brief intervention, but not in relation to the number of their hazardous drinking patients 33 52. Finally, the approach of the market research institute conducting the survey does not allow for calculation of a response rate or to characterise non-participants.…”

Prevalence and characteristics of hazardous and harmful drinkers receiving general practitioners’ brief advice on and support with alcohol consumption in Germany: results of a population survey

“…Previous surveys among GPs, however, usually only assessed how often, in general, GPs screen for alcohol or provide brief intervention, but not in relation to the number of their hazardous drinking patients. [32, 50]…”