[Austrian Consensus on High Blood Pressure 2019]. / Österreichischer Blutdruckkonsens 2019.

Elevated blood pressure remains a major cause of cardiovascular disease, disability, and premature death in Austria, with suboptimal rates of detection, treatment and control also in recent years. Management of hypertension is a common challenge for physicians with different spezializations. In an attempt to standardize diagnostic and therapeutic strategies and, ultimately, to increase the rate of patients with controlled blood pressure and to decrease the burden of cardiovascular disease, 13 Austrian medical societies reviewed the evidence regarding prevention, detection, workup, treatment and consequences of high blood pressure in general and in various clinical scenarios. The result is presented as the first national consensus on blood pressure. The authors and societies involved are convinced that a joint national effort is needed to decrease hypertension-related morbidity and mortality in our country.

[Primary Health Care in Austria - Tu Felix Austria nube - Concept for networking in the primary care of Upper Austria]. / Primary Health Care in Österreich ­ Tu Felix Austria nube ­ Konzept der Vernetzung in der primären Gesundheitsversorgung von Oberösterreich.

The primary health care in rural areas in Austria is currently determined by challenges such as ageing of the population, the shift towards chronic and age-related illnesses, the specialist medical and hospital-related education and training of physicians' as well growing widespread difficulty of staffing doctor's office. The objective is to realize a general practitioner centered and team-oriented primary health care (PHC) approach by establishing networked primary health care in rural areas of Austria. Using literature research, online survey, expert interviews and expert workshops, we identified different challenges in terms of primary health care in rural areas. Further, current resources and capacities of primary health care in rural areas were identified using the example of the district of Rohrbach. Twelve design dimensions and 51 relevant measurement indicators of a PHC network were delineated and described. Based on this, 12 design approaches of PHC concept for the GP-centered and team-oriented primary health care in rural areas have been developed.

The relationship between various psychosocial factors and physical symptoms reported during primary-care health examinations.

OBJECTIVES: The aim of the study was to determine indicators for psychosocial factors and to investigate the associations between them and physical complaints, as well as to examine possible gender-dependent differences. METHODS: This was an observational (cross-sectional) study in primary care (health examinations in several Austrian regions); participants were 312 men and 374 women aged 19-60 years. The impact of psychosocial factors on ten physical symptoms (cardiac complaints, dyspnea, gastric complaints, headaches, joint or muscle pain, dry skin, hearing impairment, tinnitus, decrease of strength and endurance, and insomnia) was analyzed using logistic regression analyses and multiple linear regression models. RESULTS: People with psychosocial stress or dissatisfaction exhibited a higher probability of reporting at least one physical symptom. Age-adjusted odds ratios (95% CI) were as follows: pressure at work 1.72 (1.08-2.73) in men and 2.53 (1.46-4.39) in women, social stress in the workplace 3.37 (1.41-8.05) in men and 3.09 (1.01-9.43) in women, sexual dissatisfaction 4.48 (1.47- 13.62) in men and 1.77 (0.80-3.96) in women, discomfort in family/partnership 4.71 (1.34-16.57) in men and 1.76 (0.66- 4.67) in women. Among men, the psychosocial parameter most strongly related to the number of physical symptoms was discomfort in family/partnership, followed by social stress in the workplace, sexual dissatisfaction, and pressure at work with means of 2.00, 1.27, 0.92 and 0.33 symptoms respectively (linear regression model, adjusted for age). Among women the strongest association found was also with discomfort in family/partnership, followed by sexual dissatisfaction, pressure at work and social stress in the workplace with means of 1.32, 1.20, 0.58 and 0.50 symptoms respectively. CONCLUSIONS: The reporting of physical symptoms is often associated with psychosocial factors and these should be taken into account during primary care and, where appropriate, should be further clarified. There are unexpected, gender-related patterns in the association of different psychosocial factors with physical symptoms that warrant further investigation.

Opinions and attitudes concerning osteoporosis among Austrian general practitioners.

General practitioners play a crucial role in the management of osteoporosis. Thus, it is essential to determine the opinions and attitudes of family doctors concerning this disease. A structured pencil-paper questionnaire was distributed to all general physicians in a practice in Austria and 3.2% responded. Results were compared with a similar survey carried out in 1993. 84.4% of the responding doctors regarded the public health impact of osteoporosis as rather or very important, compared with 49.2% in 1993. 83.3% regarded prevention of osteoporosis as effective or very effective. This proportion rose from 66.2% in 1993. Regular physical exercise was rated as most effective in the prevention of osteoporosis, followed by calcium-rich diet and vitamin D- and calcium supplementation. 33.6% reported carrying out a standardised risk assessment prior to referral/non-referral for bone mineral densitometry. The most frequently cited aspects of the patient's medical history leading to this examination were permanent corticosteroid therapy, a history of fractures, and pain, as reported by 93.6, 84.6 and 71.2%, respectively. The most frequently reported interventions recommended by doctors to their osteoporosis patients in the prevention of falls were reduction of trip hazards (87.2%), reduction of psychotropic drugs (50.0%), balance, strength and endurance training (57.7, 48.1, and 42.3%, respectively). These results reveal strengths in the approach to prevention and early recognition of osteoporosis and prevention of falls, but potential room for improvement in the management of osteoporosis by general practitioners is also shown.