Treatment of patients with arterial hypertension in family medicine in Slovenia – Assessment of the situation after the introduction of model practices
DOI:
https://doi.org/10.6016/ZdravVestn.3069Keywords:
arterial hypertension, family medicine, reference clinics, teamwork, combined therapyAbstract
Background: Most patients with uncomplicated arterial hypertension are treated by family physicians. The purpose of the research was to discuss how to consider patients with arterial hypertension in Slovenia and to assess blood pressure control.
Methods: In a prospective observational survey, in 21.11.2017 to 28.3. In 2019, six months observation time were reviewed for previously untreated patients with essential arterial hypertension in 158 family medicine clinics in Slovenia. On the end of follow up period, blood pressure (BP) control was evaluated.
Results: A total of 1060 patients were included, with the mean age 58.6 ± 12.1 years old. Among the patients included, 579 (55%) were men and 481 (45%) were women. The mean systolic BP on entry was 165.2 ± 14.5 mm H, diastolic 96.2 ± 10,0 mm Hg. 751 patients (70.8%) had associated cardio-vascular disease factors. 408 (38.5%) patients had assessed cardiovascular risk as high or very high. Antihypertensive medication was initiated in 1046 (98.7%) patients; in 418 patients (39.4%) combinatory antihypertensive therapy with two or more antihypertensive drugs in free or fixed drug combinations was initiated. 331 patients (31.6%) had a visit to a practice nurse.
929 (87.6%) patients completed the study. The mean systolic BP at the conclusion of the study was 135.4 ± 10.9 mm Hg and diastolic 81,8 ± 8,0 mm Hg. 63.3% of patients received target BP.
Conclusion: We recognized some room for improvements. In the future, it will be necessary to strengthen the team management of patients and to encourage doctors to introduce combination therapy, preferably in a fixed dose combination of two or three drugs in one tablet.
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