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Hypertension registers in general practice: levels of control and nondrug management
R J Flight1, D Snelgar, B Allan
1Health Promotion and Resource Unit, Northland Area Health Board, Omapere, Hokianga.
Insights
General practitioners established hypertension registers, leading to a significant reduction in high blood pressure readings over two years. The study suggests potential for managing 10-20% of hypertension patients without medication.
Area of Science:
- Cardiology
- Public Health
- General Practice
Background:
- Hypertension management is a key public health concern.
- Effective strategies for hypertension screening and management in primary care are essential.
Purpose of the Study:
- To evaluate the effectiveness of hypertension registers in managing blood pressure.
- To assess the potential for non-pharmacological management of hypertension.
Main Methods:
- General practitioners established hypertension registers for 3703 patients aged 20-69.
- Opportunistic blood pressure screening and follow-up over 12, 24, and 30 months.
- Hypertension defined by WHO criteria (diastolic > 95 mmHg and/or systolic > 160 mmHg).
Main Results:
- The percentage of patients exceeding WHO hypertension criteria decreased significantly over 12 and 24 months.
- A significant increase in the percentage of patients with diastolic blood pressure < 90 mmHg was observed.
- The proportion of patients managed without drugs varied, with a potential scope for 10-20% non-pharmacological management.
Conclusions:
- Hypertension registers are effective in improving blood pressure control in primary care.
- There is a notable scope for managing a significant percentage of hypertensive patients without medication.
- Further research into non-pharmacological hypertension management strategies is warranted.
Abstract:
Sixty-five general practitioners throughout Northland agreed to establish and maintain hypertension registers for a three year trial period beginning in 1982. Opportunistic blood pressure screening was undertaken of all patients aged 20-69 attending practices for whatever reason. Patients with an average of six readings on at least three separate occasions which exceeded WHO criteria for hypertension (diastolic blood pressure greater than 95 mmHg and/or systolic blood pressure greater than 160 mmHg) were entered onto the registers as were patients already receiving antihypertensive drugs. In all 3703 patients were registered. The percentage exceeding WHO criteria fell from 49.4% to 38.8% for those followed up for twelve months and from 48.6% to 34.5% for those followed up for twenty-four months. The percentage with diastolic blood pressure less than 90 mmHg increased significantly for each follow up group and with length of follow up. Overall 8.2% at entry were managed without drugs, for those followed up for thirty months this fell to 6.2% with individual practice percentage varying from nil to over twenty. There appears scope to manage between 10-20% of hypertensives without drugs.