[Factors affecting the follow up of hypertensive patients]

To study the factors affecting lack of continuity in hypertense patients' follow-up care and to define these patients' profile.

Crossover study.

Rural health district.

Systematic sample of the 1,487 hypertense patients in our health district (n = 642).

Patients' socio-demographic variables, characteristics of their AHT, treatment, risk factors and chronic illnesses were taken from the clinical records. The following were noted concerning lapses (defined as periods longer than six months without a blood pressure reading): beginning, end and number of lapses, consultations during a lapse and reasons for the consultation.

56% of the individuals in the sample had lapses. These patients consulted 2.8 times during each lapse, making a total of 1,174 consultations (47.1% acute problems; 23.5% chronic pathologies; 19.8% administrative matters and 7.5% AHT or related ailments). On comparing patients with and without lapses we found that variables with significant differences were: pensioner, education, profession, initial and current pharmacological treatment, smoker, years of the AHT's evolution and doctor. No significant differences were found for age, gender or tension figures. Lapses were less in diabetics and patients with Hypercholesterolaemia.

Although we defined an approximate profile of the patient with lapses, we found no relationship with tension figures. Both the fact that a high number of patients consult during lapses and the differences between clinics show the co-responsibility of the health factor as a cause of lack of continuity.