Waterpipe smoking: not necessarily less hazardous than cigarette smoking
BACKGROUND Lifestyle interventions in the management of hypertension were beneficial in published studies. OBJECTIVE To evaluate (1) which lifestyle recommendations are given by physicians and to what extent the possibility of drug-induced hypertension is addressed; (2) to study the characteristics of the physicians who more often perform lifestyle interventions. METHODS General practitioners in the area of Dordrecht were asked whether or not they included lifestyle advice in the management of their patients' hypertension. RESULTS Of the 176 physicians invited, 105 consented to take part. Measures to reduce body weight, stopping smoking, and physical exercise advice were given by 94, 92, and 92% of the physicians, respectively. Advice on psychological relaxation and reducing liquorice (Dutch: drop) intake was only given by 23 and 32%. Rural physicians were more active: they more often recommended quitting smoking (p<0.02), reducing weight (p<0.02), and participating in sporting activities (p<0.02). And so were older physicians: they more often recommended starting low-calorie diets (p<0.05), stopping liquorice consumption (p<0.04) and emphasised drug compliance (p<0.02). Increased blood pressure as a side effect of concomitant medications, other than nonsteroidal anti-inflammatory drugs and oral contraceptives, was virtually never addressed. CONCLUSIONS (1) Advice to reduce body weight, stop smoking, and increase physical exercise are the only lifestyle recommendations routinely given, (2) rural physicians and older physicians were more active in giving non-drug treatments, (3) increased blood pressure as a side effect of medications was virtually never addressed. (Neth Heart J 2009;17:9-12.).