Hypotension--does it Make Sense in Family Practice?

In general practice many diagnostic labels are used that arerelated to cultural background rather than a scientific basis.To estimate the use of diagnoses like ‘hypotension’and depression, a cross-sectional survey in German and BritishGPs' surgeries was performed. Prevalence of related symptoms,socio-demographic and medical data were recorded as well asactual and previous blood pressure levels. In German generalpractice, where ‘hypotension’ is an establishedentity, 17% of all patients attending were reported as hypotensiveeither by their doctor or by themselves. The proportion wastwice as high among women than among men. It was more commonamong the young. One-quarter of these patients were on medicationto raise their blood pressure. Actual and previous blood pressurelevels failed to explain the occurrence of symptoms like tiredness,dizziness, headache etc. Demographic characteristics of patientsdiagnosed as depressed were similar in both countries. Presumablyfor economic reasons there is a tendency for German GPs to usemore diagnostic labels of any kind. It was concluded that diagnosticlabels attached to vague but frequently presented symptoms varyconsiderably between countries. They often lack a physiologicrationale. Nevertheless they often support the tendency to somatizecommon problems.