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European guidelines on lifestyle changes for management of hypertension

Awareness and implementation of recommendations among German and European physicians

Leitlinienempfehlungen zu Lebensstiländerungen für das Hypertoniemanagement

Kenntnis und Implementierung der Empfehlungen unter deutschen und europäischen Ärzten

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Abstract

Background

In the 2013 European Society of Hypertension (ESH) and European Society of Cardiology (ESC) guidelines for the management of arterial hypertension, six lifestyle changes for treatment are recommended for the first time with class I, level of evidence A. We initiated a survey among physicians to explore their awareness and consideration of lifestyle changes in hypertension management.

Methods

The survey included questions regarding demographics as well as awareness and implementation of the recommended lifestyle changes. It was conducted at two German and two European scientific meetings in 2015.

Results

In all, 1064 (37.4% female) physicians participated (806 at the European and 258 at the German meetings). Of the six recommended lifestyle changes, self-reported awareness was highest for regular exercise (85.8%) followed by reduction of weight (66.2%). The least frequently self-reported lifestyle changes were the advice to quit smoking (47.3%) and moderation of alcohol consumption (36.3%). Similar frequencies were observed for the lifestyle changes implemented by physicians in their care of patients.

Conclusion

A close correlation between awareness of guideline recommendations and their implementation into clinical management was observed. European physicians place a stronger emphasis on regular exercise and weight reduction than on the other recommended lifestyle changes. Moderation of alcohol consumption is the least emphasized lifestyle change.

Zusammenfassung

Hintergrund

In den Leitlinien der European Society of Hypertension (ESH)/European Society of Cardiology (ESC) von 2013 zum Management der arteriellen Hypertonie werden erstmalig 6 Lebensstiländerungen mit einer Klasse I, Evidenzgrad A zur Behandlung empfohlen. Die Autoren führten eine Umfrage unter deutschen und europäischen Ärzten zur Einschätzung ihrer Kenntnis dieser Lebensstiländerungen sowie deren Implementierung im eigenen klinischen Hypertoniemanagement durch.

Methoden

Die Umfrage beinhaltete Fragen zu demographischen Daten der Teilnehmer, zum Kenntnisstand über die empfohlenen Lebensstiländerungen sowie deren Anwendung in der Praxis. Die Umfrage erfolgte 2015 im Rahmen von 2 deutschen und 2 europäischen Kongressen.

Ergebnisse

Es nahmen 1064 Ärzte (37,4 % Frauen) teil (806 bei den europäischen, 258 bei den deutschen Kongressen). Von den 6 empfohlenen Lebensstiländerungen waren regelmäßige Bewegung (85,8 %) und Gewichtsreduktion (66,2 %) am häufigsten spontan bekannt. Der Kenntnisstand war am geringsten hinsichtlich einer Beratung, das Rauchen aufzugeben (47,3 %), und der empfohlenen Beschränkung des Alkoholkonsums (36,3 %). Ähnliche Häufigkeiten fanden sich bei den Angaben der Umfrageteilnehmer zu den im eigenen klinischen Hypertoniemanagement empfohlenen Lebensstiländerungen.

Schlussfolgerung

Die Ergebnisse belegen eine enge Korrelation zwischen Kenntnis über die Leitlinienempfehlungen und deren Empfehlung in der klinischen Praxis. Europäische Ärzte betonen regelmäßige Bewegung und Gewichtsreduktion stärker als die anderen empfohlenen Lebensstiländerungen, wobei eine Beschränkung des Alkoholkonsums am wenigsten Beachtung findet.

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Acknowledgements

We are thankful for excellent support to Dr. Angelika Thomas and Dr. Rhoda Wismer (signum-PR GmbH, Cologne). The survey results were presented in abstract form at the 26th European Society of Hypertension Meeting 2016 in Paris. This survey was funded by Lundbeck AS (Valby, Denmark).

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Authors and Affiliations

  1. Institut für Klinische Pharmakologie und Toxikologie, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany

    J. Bolbrinker, L. Zaidi Touis & R. Kreutz

  2. Neue Kirchstr. 22, 79282, Ballrechten-Dottingen, Germany

    H. Gohlke

  3. Institut für Sportwissenschaft, Arbeitsbereich Sportmedizin, Christian-Albrechts-Universität zu Kiel, Olshausenstraße 74, 24098, Kiel, Germany

    B. Weisser

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  1. J. Bolbrinker
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Correspondence to J. Bolbrinker.

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J. Bolbrinker, L. Zaidi Touis, H. Gohlke, B. Weisser, and R. Kreutz declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Bolbrinker, J., Zaidi Touis, L., Gohlke, H. et al. European guidelines on lifestyle changes for management of hypertension. Herz 43, 352–358 (2018). https://doi.org/10.1007/s00059-017-4575-0

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