Doctor points to hypertension gap

Yu Zhenqiu, director of the hypertension department at Anzhen Hospital in Beijing, talks to a patient on Friday. Provided to China Daily

The key to the overall success of hypertension control in China is improved clinical capacity for grassroots level physicians and a multidisciplinary approach to intervention, according to a senior specialist.

The country currently has 330 million hypertension sufferers and the condition is spreading, according to the National Health and Family Planning Commission. About 46 percent of the sufferers are aware of their condition, and 41 percent receive treatment.

However, only 14 percent have their blood pressure under good control.

Nearly 90 percent of patients were treated at county-level hospitals or even smaller ones.

"The gap is largely due to poor management and limited capacity at the grassroots level and a lack of concerted efforts," said Yu Zhenqiu, director of the hypertension department at Anzhen Hospital in Beijing.

Hypertension has become a widespread disease, he said, so it is essential for society to undertake mass prevention and treatment, a process that requires the participation of different levels of medical institutions and doctors.

To help with capacity building for follow-up treatment and behavior intervention, Yu suggested training programs highlighting the key role of county-level hospitals.

Currently, China has more than 12,000 county-level hospitals, accounting for half of all health institutions nationwide. They are handling the medical needs of 70 percent of the entire population.

"Their competence is key to overall success," Yu said.

Doctors from county-level hospitals should regularly participate in one- to three-month training programs led by senior specialists at large hospitals, Yu said. In turn, the doctors can spread the knowledge and skills learned to physicians at township-level hospitals or village clinics.

Yu has helped train dozens of grassroots physicians nationwide.

Zhang Hongyu, a medic in the public health department of a township-level hospital in the Inner Mongolia autonomous region, said the training by Yu was helpful but "a very rare opportunity for doctors at the grassroots level".

She now is on a one-month training program in Yu's department.

Through the on-site training, she said, "I got to know how to treat people with a combination of drugs and to administer related health checks for more targeted intervention."

Yu suggested the health authorities should mobilize senior specialists to help train doctors at county-level hospitals.

Such training should be carried out and coordinated by the hypertension departments of large hospitals, highlighting a multidisciplinary treatment approach.

At Anzhen, Yu set up related specialty groups - kidney, endocrinology, the nervous system, and maternity - within the hypertension department.

These specialties are interrelated, he said. For example, "getting hypertension under control helps with intervention in heart disease", he said.

In a conventional approach, heart disease cannot be diagnosed until a patient shows evident symptoms, such as chest tightness, pain and heart palpitation. But many early-stage cardiology patients show no symptoms at all.

As hypertension is treated, he said, "sometimes heart diseases are diagnosed well before the onset of cardiac symptoms". That helps prevent life-threatening heart attacks.

That demonstrates the importance of an independent hypertension department, he said, adding that many large hospitals currently have such as department.