Clinicians' time in different aspects of hypertension care: how far are we from optimal management required by guidelines? Results of an international survey of the working group of general practitioners' and team-based care of the European Society of Hypertension and the European General Practice Research Network.

Abstract

Background: Hypertension management guidelines provide recommendations for optimal patient care. However, the limited time available of clinicians is rarely considered. The aim of this study was to evaluate the time clinicians currently spend on different components of hypertension care during an average workday and to assess physicians' perceptions of the time required for optimal, guideline-based care.

Methods: We conducted an international, cross-sectional, anonymous questionnaire-based survey among physicians involved in hypertension care. A 37-item questionnaire assessed time spent on, and time perceived as necessary for, guideline-recommended hypertension-related activities during an average workday. The survey was distributed through the European Society of Hypertension (ESH) and the European General Practice Research Network (EGPRN) between 1 June and 15 September 2025.

Results: 370 responses were collected from 49 countries worldwide (91.3% from Europe). After data clarification 357 responses were analysed. Of these, 153 (42.9%) were general practitioners (GPs) and 204 (57.1%) were other specialists (internists, cardiologists, nephrologists). Across all assessed activities, clinicians consistently reported a gap between the time currently spent and the time perceived as necessary for optimal care, including office blood pressure measurement, home blood pressure measurement education, lifestyle counselling, and cardiovascular risk stratification. Differences were also observed between the practice of GPs and other specialists.

Conclusions: This international survey demonstrates substantial perceived gaps between available and required time for several components of hypertension care, particularly in general practice. These findings highlight the importance of considering real-world clinician time constraints in the development and prioritisation of hypertension guideline recommendations and suggest that adequate health-system resources are needed to support their implementation.