SAGE-Hindawi Access to Research
International Journal of Hypertension
Volume 2011, Article ID 983869, 6 pages
doi:10.4061/2011/983869
Research Article
Knowledge and Practice of PHC Physicians toward the Detection
and Management of Hypertension and Other CVD Risk Factors in
Egypt
Mostafa A. Abolfotouh,
1
Laila A. Soliman,
2
Sameh M. Abolfotouh,
2
and Mohamed Raafat
3
1
Biobanking Section, King Abdullah International Medical Research Center, King Saud Bin-Abdulaziz University for Health Sciences,
P.O. Box 22490, Riyadh 11426, Saudi Arabia
2
Primary Health Care Department, Ministry of Health and Population, Cairo 21526, Egypt
3
Strengthening Rural Health Services Project, Ministry of Health and Population, Cairo 21526, Egypt
Correspondence should be addressed to Mostafa A. Abolfotouh, mabolfotouh@gmail.com
Received 24 April 2011; Revised 20 June 2011; Accepted 22 June 2011
Academic Editor: Roberto Pontremoli
Copyright © 2011 Mostafa A. Abolfotouh et al. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Aim. To assess the knowledge and practice of PHC physicians toward the detection and management of hypertension (HTN) and
other CVD risk factors. Methods. A cross-sectional study of all primary health care physicians of the FHU of three rural districts of
Egypt was conducted. Each physician was subjected to a prevalidated interview questionnaire on the WHO-CVD risk management
package for low and medium resources, and a checklist of observation of daily practices. Results. Hypertension was a priority
problem in about two-thirds (62.9%) of physicians, yet only 19% have guidelines for HTN patients. Clinical history recording
system for HNT was available for 50% of physicians. Levels of knowledge varied with regard to definition of HTN (61.3%, fair),
procedures for BP measurement (43.5%, poor), indications for referral (43.5%, poor), patient counseling (61.3%, fair), patient
treatment (59.8%, fair). Availability of clinical history recording system for HNT was a significant predictor for physician’s level of
knowledge (P = 0.001). Overall level of practice was fair (68.5%). Conclusion. PHC physicians have unsatisfactory knowledge and
practice on hypertension. There is a need of more continuing medical education. Local and international manuals, workshops,
and seminars on how to make use of these guidelines would improve doctors’ performance.
1. Introduction
Hypertension is confirmed to be a major health problem
in Egypt with a prevalence rate of 26.3% among the adult
population (>25 years) [1], with the highest prevalence in
greater Cairo (31%) and Northern Upper Egypt (30.7%) and
the lowest rate in the frontiers governorates (19.9%). Almost
two-thirds (62.5%) of those who could be classified as hyper-
tensive are not aware that they have high blood pressure (BP).
At national level, the estimated percentage of hypertensive
individuals receiving pharmacological treatment in Egypt
was 23.9%, but the hypertension was controlled in only 8%
[2].
In this context, hypertension presents a major area
of intervention because it is a frequent condition and
is amenable to control through both nonpharmacological
lifestyle factors and pharmacological treatment. Pharmaco-
logical treatment for hypertension has been shown to be
effective in decreasing BP and subsequently cardiovascular
events [3] although BP levels achieved in treated patients may
still be considerably higher than those in truly normotensive
persons. Lifestyle measures for lowering BP include reduced
alcohol intake, reduced sodium chloride intake, increased
physical activity, and control of overweight [4–8]. Lifestyle
interventions also have the potential to reduce the need for
or the amount of medications in hypertensives and prevent
high BP from developing in nonhypertensives. Further-
more, lifestyle interventions are instrumental in controlling
other concomitant cardiovascular risk factors not necessarily
related to hypertension, such as smoking, raised cholesterol