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90 ‘People say it is dangerous’. psychosocial effects of labelling people with mild hypertension: a qualitative study
  1. János Valery Gyuricza1,2,
  2. John Brodersen2,
  3. Lucas Bastos1,
  4. Ana Flávia D’Oliveira1
  1. 1Departamento de Medicina Preventiva da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
  2. 2Forskningsenheden for Almen Praksis Center for Sundhed og Samfund Københavns Universitet, Copenhagen, Denmark

Abstract

Mild hypertension is a very common asymptomatic condition present in people at low cardiovascular risk. These people represent the greatest amount of those labelled with hypertension. Best available evidence does not support pharmacologic treatment for mild hypertension in order to reduce cardiovascular mortality. Moreover, overdetection of hypertension is also taking place supported by public awareness campaigns, screening programmes, easy access to testing and poor clinical practice, enhancing the overdiagnosis potential. Evidence suggests that this diagnosis is harmful in many ways: from side effects of treatment to psychosocial consequences of labelling. However, the psychosocial effects of labelling are potential harms that still need better understanding.

Objectives The aim of this study was to assess the potential psychosocial labelling effects in people diagnosed with mild hypertension.

Method 10 Single and 5 focus group interviews were conducted in São Paulo, Brazil among persons labelled with mild hypertension without comorbidities. Volunteers were selected among general population either from a list of patients from a primary healthcare clinic or social media and social network, with a broad range of characteristics including sex, age, level of education, ethnic origin and time from diagnosis. Data was subjected to qualitative content analysis by three of the authors independently followed by discussions to generate themes and categories.

Results Preliminary results confirm that the label has impacts in a broad range of psychosocial dimensions, e.g. trust in own body, psychological reactions, social stigma and overmedicalization. Although informants had a broad range of characteristics, they shared similar stories, understandings and effects of labelling. The empirical material is still being analysed and final results will be presented at the conference.

Conclusions The diagnosis of mild hypertension is a relevant milestone and has impact on daily life. Most of the impact is regarded as a negative consequence or harm; however, sometimes it might be ambiguous.

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