Healthy diet, healthy heart, healthy prostate.
31 December 2007
Aust Fam Physician. 2007 Oct;36(10):791
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Family Medicine Update
Important Medical news for family physicians and primary care providers
Obesity and pre-hypertension in family medicine: Implications for quality improvement.
31 December 2007
BMC Health Serv Res. 2007 Dec 21;7(1):212
ABSTRACT: BACKGROUND: Prevention of pre-hypertension is an important goal for primary care patients. Obesity is a risk factor for hypertension, but has not been addressed for pre-hypertension in primary care populations. The objective of this study was to assess the degree to which obesity independently is associated with risk for pre-hypertension in family medicine patients. METHODS: This study was a retrospective analysis of information abstracted from medical records of 707 adult patients. Multivariable logistic regression was used to test the relationship between body mass index (BMI) and pre-hypertension, after adjustment for comorbidity and demographic characteristics. Pre-hypertension was defined as systolic pressure between 120 and 139 mm Hg or diastolic pressure between 80 and 89 mm Hg. RESULTS: In our sample, 42.9% of patients were pre-hypertensive. Logistic regression analysis revealed that, in comparison to patients with normal body mass, patients with BMI>35 had higher adjusted odds of being pre-hypertensive (OR=4.5, CI 2.55-8.11, p<.01). BMI between 30 and 35 also was significant (OR=2.7, CI 1.61-4.63, p<0.01) as was overweight (OR=1.8, CI 1.14-2.92, p=0.01). CONCLUSIONS: In our sample of family medicine patients, elevated BMI is a risk factor for pre-hypertension, especially BMI>35. This relationship appears to be independent of age, gender, marital status and comorbidity. Weight loss intervention for obese patients, including patient education or referral to weight loss programs, might be effective for prevention of pre-hypertension and thus should be considered as a potential quality indicator.
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Rev Med Chil. 2007 Sep;135(9):1209-15
Medical schools curricular planning aim to obtain a physician trained to work as general practitioner and the Chilean health reform, considers ambulatory primary care as the main axis of health care. However there is still a low interest among physicians to work in primary health care, where there are problems related to a low level of clinical resolution, clinical and administrative management deficiencies and a low level of leadership in health promotion. The causes of these deficiencies stem from university training, government policies and the great attraction that exerts the technological and specialized model of secondary and tertiary health care. We analyze the ideal profüe that the general practitioner should have in our health care system and the possible solutions to primary health care problems. We also emphasize the need to coordinate the professional resource needs with university training, to reduce the existing gaps between medical training and professional practice.
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