Aim. To assess the knowledge and practice of PHC physicians toward the detection and management of hypertension (HTN) and other CVD risk factors. Methods. A cross-sectional study of all primary health care physicians of the FHU of three rural districts of Egypt was conducted. Each physician was subjected to a prevalidated interview questionnaire on the WHO-CVD risk management package for low and medium resources, and a checklist of observation of daily practices. Results. Hypertension was a priority problem in about two-thirds (62.9%) of physicians, yet only 19% have guidelines for HTN patients. Clinical history recording system for HNT was available for 50% of physicians. Levels of knowledge varied with regard to definition of HTN (61.3%, fair), procedures for BP measurement (43.5%, poor), indications for referral (43.5%, poor), patient counseling (61.3%, fair), patient treatment (59.8%, fair). Availability of clinical history recording system for HNT was a significant predictor for physician's level of knowledge ( ). Overall level of practice was fair (68.5%). Conclusion. PHC physicians have unsatisfactory knowledge and practice on hypertension. There is a need of more continuing medical education. Local and international manuals, workshops, and seminars on how to make use of these guidelines would improve doctors' performance. 1. Introduction Hypertension is confirmed to be a major health problem in Egypt with a prevalence rate of 26.3% among the adult population (>25 years) [1], with the highest prevalence in greater Cairo (31%) and Northern Upper Egypt (30.7%) and the lowest rate in the frontiers governorates (19.9%). Almost two-thirds (62.5%) of those who could be classified as hypertensive are not aware that they have high blood pressure (BP). At national level, the estimated percentage of hypertensive individuals receiving pharmacological treatment in Egypt was 23.9%, but the hypertension was controlled in only 8% [2]. In this context, hypertension presents a major area of intervention because it is a frequent condition and is amenable to control through both nonpharmacological lifestyle factors and pharmacological treatment. Pharmacological treatment for hypertension has been shown to be effective in decreasing BP and subsequently cardiovascular events [3] although BP levels achieved in treated patients may still be considerably higher than those in truly normotensive persons. Lifestyle measures for lowering BP include reduced alcohol intake, reduced sodium chloride intake, increased physical activity, and control of overweight [4–8]. Lifestyle
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