235Public Health Efforts for Earlier Resistant Hypertension
Diagnosis
From a public health sense, hypertension is the flagship contributor to the pioneering
cause of premature death and disability worldwide – cardiovascular disease [ 8 ]. For
these reasons, family physicians have been overpowered over the years by informa-
tion and admonishments concerning hypertension. Such information comes from
diverse sources. Industry representatives encourage physicians to prescribe drug A
instead of drug B. Specialists and key influencers provide complicated messages on
which drugs and diagnostic or therapeutic strategies to exercise. Clinical trials are
conflicting or contradictory from time to time. Guidelines are comprehensive and
often seem to differ between various medical institutions. It is no doubt that family
physician has confused for that reason. The last disrespect is that published articles,
specialists, and various organizations continuously tell family physician what a
loose job they are doing in the management of hypertension, either straight-out or
by implication. Articles in journals assert that “specialized” hypertension care is
better than “ordinary” care. On the contrary, publications that actually furnish real-
life, helpful advice in hypertension management are scarce, if any. Furthermore, in
spite of the reprimand toward family physicians, almost no infrastructure or
resources have been given to improve the level of “ordinary” care. Many of these
issues have begun to be recognized by professional institutions, health authorities,
and governments. The constructive problems with regard to the hypertension man-
agement in primary care have not gone overlooked. Consequently, a few initiatives
are initiated to give better support to family physicians and to the health-care system
in the management of hypertension in general. Therefore, chronic care model is
established to improve the level of care for persons having chronic diseases [ 9 ]. In
this model, the presentation of care is treated under various domains that include
health system organization, community resources, information systems, decision
support, patient self-management, and delivery system design. Until now, there has
been rare organized effort for prevention, early detection, and ongoing management
of chronic diseases. Furthermore, two systems of care appear to be developed: the
specialist-based acute care system and family physician- based primary care system.
These two systems have separated and appear to function independently from each
other. The diseases like hypertension are now being mentioned system-wide in an
integrated fashion. For instance, the presentation of hypertension care may begin
with a central disease registry. This lets the system to know a submitted patient with
a particular disease. Later, the level of disease complexity and severity may pave the
way for triaging patients to the most suitable care. This may refer to that patients
such as those with just diagnosed hypertension are treated by family physician,
whereas patients with resistant or complex hypertension are treated by a specialized
team. The association of family doctors creates primary care networks that is
responsible for managing patients with chronic diseases and granted with extra
funding for this purpose. To cater this care, these primary care networks are recruit-
ing allied health professionals such as nurses, nurse practitioners, pharmacists,
15 Public Health Efforts for Earlier Resistant Hypertension Diagnosis...