News · Longevity & Aging
Cardiology professionals were less likely than the public to take recommended blood pressure drugs
Heart specialists spend their working lives telling other people to manage risk factors. Screening 1,366 of them at a cardiology congress and comparing against 2,732 matched members of the public.
- Fewer than a third who should have been on blood pressure treatment were taking it.
- In the matched public sample, closer to half were.
- The same gap appeared, larger, for glucose-lowering treatment.
- They did better than the public on reaching cholesterol targets.
- Excess weight was the commonest modifiable risk factor among them, at almost half.
There is an old and slightly cheap joke about doctors ignoring their own advice. It turns out to have a measurable version.
Writing in the European Heart Journal, researchers set up a screening station at a large cardiology congress and assessed the people attending. Blood pressure, cholesterol, glucose, weight, and in a subgroup an ultrasound of the neck arteries to look for plaque.
Why this is a real question
Healthcare professionals play a central role in preventive care, and their own cardiovascular health management remains poorly documented. Previously nobody had screened them at scale and set the result against the public they advise.
That gap matters for a reason beyond curiosity. If the people who best understand the evidence still do not act on it, the barrier is not information, and health campaigns built on supplying information will keep missing.
What the screening found
Among 1,366 attendees, almost half carried excess body weight, which was the commonest modifiable risk factor. About a quarter had raised blood pressure and a similar share raised cholesterol.
Roughly one in nine already had established arterial disease. Among those who did not, more than one in five had plaque visible on ultrasound without knowing it.
Those are not the numbers of an unusually healthy group.
The comparison that gives it force
Set against age- and sex-matched people from the general population, the detection picture was unremarkable. Unrecognized high cholesterol, blood pressure and diabetes ran at about the same rates in both. Awareness was higher only for cholesterol.
The treatment picture was not unremarkable. Among those in primary prevention who met criteria for it, fewer than a third of the professionals were taking recommended blood pressure treatment, against closer to half of the matched public.
For glucose-lowering treatment the gap was wider still, with the professionals substantially less likely to be on it.
The exception, which is informative
They did better on cholesterol. Considerably more of them reached the recommended target than the matched public did.
That inconsistency is the most useful thing in the study. A group who are undertreated for blood pressure and glucose but well treated for cholesterol are not simply neglecting themselves across the board.
Cholesterol treatment is the part of prevention with the strongest evidence and the simplest execution: one tablet, no monitoring for most people, a clear target number. Blood pressure and glucose management require ongoing measurement and adjustment, which requires having a clinician rather than being one.
What this cannot tell you
People who attend an international cardiology congress are not a random sample of health professionals, let alone of anyone else. They are self-selected, mobile, and willing to be screened at a conference stand.
The comparison group comes from a separate population project, matched on age and sex but not on income, occupation or health literacy, all of which differ enormously between the two.
And the study reports the treatment gap without explaining it. Every account of why is speculation, including the plausible ones.
What to take from it
To prevent heart disease, you need to manage the risk factors you have, and this is a group who could recite that list from memory and were still less likely than the public to be treated for two thirds of it.
Knowing is not the constraint. The constraint looks like the ordinary machinery of being someone’s patient, which specialists appear to opt out of as readily as anyone, and rather more so.
People also ask
What did the study find?
Among 1,366 healthcare professionals, excess body weight was the most prevalent modifiable risk factor (46.8%), then hypertension (23.2%) and hyperlipidaemia (22.7%). Established atherosclerotic disease was present in 11.1%, and subclinical atherosclerosis in 21.8% of those without it. In primary prevention they were less likely than matched controls to use recommended antihypertensive (27.6% vs 46.5%; P < 0.001) or glucose-lowering therapy (60.0% vs 85.0%; P = 0.001), but more often achieved LDL cholesterol targets (57.5% vs 32.0%; P < 0.001).
Who exactly was screened?
Healthcare professionals attending a major cardiology congress, assessed on the spot for blood pressure, lipids, glucose and body weight, with neck artery ultrasound in a subgroup. They were compared against age- and sex-matched people from a general population project.
What is subclinical atherosclerosis?
Fatty plaque visible in an artery on ultrasound in someone with no symptoms and no diagnosis. It is the disease present but silent, and it is the reason a person can feel entirely well and still be years into the process.
Were they simply unaware of their risk factors?
Mostly not. Unrecognized high cholesterol, high blood pressure and diabetes were about as frequent as in the general population sample, and awareness was measurably higher only for cholesterol. So the gap is largely in treatment rather than in detection.
Why would specialists undertreat themselves?
The study does not answer that. Plausible explanations include treating oneself informally, discounting one's own risk, and simply not having a doctor of one's own, but this design cannot distinguish them.
Why did they do better on cholesterol?
Cholesterol treatment is the part of prevention where the evidence is strongest and the drugs are simplest to take. That may make it the easiest thing to act on without an ongoing relationship with a clinician.
What does this mean for a reader?
Mainly that professional knowledge does not translate into personal action, which is worth knowing when taking anyone's example rather than their advice. This is general information rather than medical advice.