Differences in Inpatient Hypertension Management Practices Between Specialists and Non-specialists in Zhejiang Province, China.

OBJECTIVE To investigate the differences in management practices for hospitalized hypertensive patients between cardiovascular specialists and non-specialists, identify key determinants affecting the quality of blood pressure (BP) control, and offer evidence-based recommendations to support the standardization of hypertension management protocols.

METHODS A retrospective analysis was conducted on the medical records of 500 inpatients with essential hypertension at Zhejiang Provincial People's Hospital in January 2022. BP control rates, drug adjustments, and monitoring practices were compared between specialist and non-specialist treatment groups. Statistical analyses were performed using SPSS 25.0, with variance analysis for continuous variables and chi-square tests for categorical variables. Multivariable logistic regression was used to identify independent predictors of BP control at discharge.

RESULTS At admission, the overall BP control rate was 36.2%, with no significant difference between the non-specialist and specialist groups (37.5% vs. 34.0%, P > 0.05). At discharge, the specialist group demonstrated a significantly higher BP control rate than the non-specialist group (72.9% vs. 63.0%, P < 0.05). The specialist group also showed significantly higher rates of drug adjustment (72.9% vs. 20.2%), combination therapy (84.0% vs. 49.8%), and completeness of discharge instructions (90.4% vs. 28.5%) compared to the non-specialist group (all P < 0.01). In multivariable logistic regression, specialist care remained independently associated with achieving target BP (aOR = 1.755, 95% CI: 1.129-2.728, P = 0.012), while diabetes, stroke/transient ischemic attack, chronic kidney disease, and higher hypertension grade were identified as independent risk factors for poor BP control.

CONCLUSION Cardiovascular specialists achieved significantly better BP control through more frequent drug adjustments and optimized combination therapy regimens. Non-specialists exhibited deficiencies in monitoring, medication regimen optimization, and follow-up management. It is recommended to enhance standardized training for non-specialists in hypertension management to improve overall hypertension prevention and control.