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Missed opportunities to prevent hypertension at a tertiary care centre in Pakistan

Syed Muhammad Ashraf Jahangeer1, Shehzeen Dua Bhatti1,2, Muhammad Hammad1,2

  • 1Department of Community Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.

Eastern Mediterranean Health Journal = La Revue De Sante De La Mediterranee Orientale = Al-Majallah Al-Sihhiyah Li-Sharq Al-Mutawassit
|November 10, 2023
PubMed

Insights

High rates of missed opportunities for cardiovascular disease prevention were found in Pakistan. Many patients with hypertension risk factors did not receive physician counseling, highlighting a need for improved primary care integration.

Area of Science:

  • Public Health
  • Cardiology
  • Preventive Medicine

Background:

  • Cardiovascular disease (CVD) is a leading global cause of mortality, impacting 1.28 billion adults.
  • A significant portion of affected adults (46%) are unaware of their condition, and one-third do not receive adequate care.
  • Missed opportunities in CVD prevention contribute to the global health burden.

Purpose of the Study:

  • To identify missed opportunities in the prevention of cardiovascular disease (CVD).
  • To investigate the prevalence of CVD risk factors among patients.
  • To assess physician practices regarding CVD risk factor counseling.

Main Methods:

  • A study involving 359 adult outpatients (aged 18-77) at Civil Hospital, Karachi, Pakistan.
  • Data collected included sociodemographics, consultation duration, anthropometrics, and blood pressure.
  • Physician practices regarding medical history, examination, and risk factor counseling were evaluated.

Main Results:

  • Nearly all participants (98%) presented with at least one hypertension risk factor.
  • Only 35.9% of high-risk individuals (≥3 risk factors) received physician counseling on hypertension.
  • A substantial missed opportunity rate of 37.6% was identified for hypertension prevention.

Conclusions:

  • High frequency of missed opportunities for CVD prevention and hypertension risk factor management was observed.
  • Physician workload and the primary use of outpatient departments for general ailments contributed to these missed opportunities.
  • Establishing primary care clinics within tertiary settings is recommended for effective CVD risk factor evaluation and patient referral.
Abstract

Keywords:
Pakistancardiovascular diseasehypertensionpreventiontertiary care

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