Systemic Arterial Hypertension: the View of Teachers in Medical Training

ABSTRACT We investigated the social representations of medicine teachers from a University in Santa Catarina state regarding their clinical approach to people with hypertension. This was a qualitative study employing semi-structured interviews with a convenience sample of eight teachers, each representing a field included in undergraduate medical internship. The collected data were analyzed according to the Collective Subject Discourse (DSC) methodology applying the resources of central ideas and key expressions. We verified that people with hypertension are identified by the subjects when they seek medical attention for different purposes: medical examination for complaints not related to hypertension, health check-ups, emergency situations, referrals from other professionals or even complaints that the person attributes to hypertension. The medical teachers identified a lack of association between hypertension and symptoms, attributing that association to those afflicted with hypertension, even though the subjects talked of hypertension more like as a disease, than a risk factor. Poor treatment adherence emerged as a limitation of non-pharmacological measures as much as of the pharmacological ones, pointing to the difficulties involved in justifying the lifestyle modifications usually prescribed to deal with a risk factor that is not identified as an illness when there are no associated complications defining disease situations. We suggest the importance of adequately defining hypertension as a risk factor throughout medical undergraduate training, in order to avoid disease mongering. Hypertension must be approached applying a joint problem management plan involving the physician and the person with hypertension.