Effective control of hypertension: a project of the Hungarian society of hypertension, baseline data

Abstract

The aim of the project is to assess the quality and improve the preventive and curative practices at the primary care level in Hungary. A total of 50 general practitionaires were selected on a voluntary basis in Budapest, Hungary, and from them, 30 were randomized to the intervention (I) group and 20 to the reference (R) group. The members in the I group have been trained for the official hypertension guideline and their everyday work is monitored. Those in the R group have only been monitored to measure the efficacy of the training. In all, 10% from the known hypertensive persons (N ¼ 10,799) and 5% of the remaining (nonhypertensive) patients (N ¼ 60,341) were selected randomly from the GP's computer files and invited for screening investigation performed by trained medical students. They measured the blood pressure of patients, assessed the cardiovascular risk status and the quality of education of patients by standardized questionnaires. In total, 4083 patients were invited, but only 39.2% attended the screening visit. The prevalence of undetected hypertension was 34.6%. This prevalence was significantly higher in the older (460 years: 46.8%) than in the younger (o50 years: 20.8%, Po0.0001) age group and it was higher in men (41.5%) than in women (30.1%, Po0.001). The proportion of H patients on drug treatment was 85.3% and the frequency of patients under effective blood pressure control (ego140/90 mmHg) was 27.8%. Counselling to patients for a healthier lifestyle (exercise, smoking, alcohol consumption, diet) was very rare. In conclusion, our data represent the primary care of Budapest and may not be relevant to the whole country. As a consequence of this study, education of primary care physicians and patients is a must for further improvement of hypertension care.

Compliance with hypertension guidelines in general practice in Slovenia

“…Physicians advised all recommended non-pharmacological measures to less than a half of all the hypertensive patients. The results are similar in Germany [29] and better than results from Hungary, which showed that only one quarter of hypertensive patients got all recommended non-pharmacological measures in hypertension [30].…”

“…Almost two thirds of the patients had combined antihypertensive therapy, most frequently a fixed combination of two different drugs. The proportion of patients on combined therapy is similar to other European countries [29,30,33]. In case of three or more different classes of antihypertensive drugs, a diuretic was included in such a combination.…”

“…Most of the patients with diagnosis of arterial hypertension (98.7%) who attended general practice were treated with antihypertensive drugs and less than 2% of patients were treated only with non-pharmacological measures. The percentage of patients receiving pharmacological treatment for hypertension was 83.8% in Germany [29], 85% in Finland and Hungary [30,33] and 90% in Greece [34].…”

Neurovascular Pulsatile Compression and Neurosurgical Decompression of the Rostral Ventrolateral Medulla in Medically Resistant Hypertensive Patients

“…In more than 25% of treated HT patients, the target blood pressure (BP) is not reached [1][2][3] . Around 90-95% of the cases involve primary HT (PHT).…”

Detection and treatment of hypertension in general health-care practice: a patient-based study

“…[1][2][3][4][5][6] A Swedish study estimates that, among an adult population of 1.8 million, 60% have mild HT (140-159/90-99 mmHg), 30% moderate HT (160-179/100-109 mmHg) and 10% very high HT (X180/ X110). 1 In a representative German nationwide primary care sample, the point prevalence of HT was reported as 40.1%.…”