[Results of the "Health Program Hypertension" of the German Health Insurance (DKV)].

BACKGROUND AND OBJECTIVE

In 2003 the German Health Insurance (DKV: Deutsche Krankenversicherung) initiated a "Health Program Hypertension" for its insured persons with the aim of motivating patients to adopt the accepted general measures for blood pressure reduction and to self-monitor their blood pressure.

PATIENTS AND METHODS

Participation in the program was voluntary and without charge. The interventional measures included regular contact by phone with trained medical personnel, personal consultations targeting general measures and self measurement of blood pressure. Each patient was given training material and a blood pressure monitor, and a risk profile was made for each patient. Regular reports were given to the patients and their physicians.

RESULTS

The data of the first 1373 hypertensives who have been in the continuing program were analysed. The patients" average age was 61+/-9.9 years, 81% males. 94% of the participants reported taking antihypertensive medication. Initially 615 patients (44.8%) had an increased blood pressure on self-measurement ((3)135/85 mmHg). The blood pressure of these patients was significantly reduced, after an average of 16.3 months, from 145/91+/-12.7 mmHg to 135/84 +/-12.8 mmHg (p<0.001). A statistically significant weight reduction was achieved in 308 patients (22.4%) with a body mass index (BMI) of (3) 30 kg/m2, from 33.4 to 32.9 kg/m2 (p<0.001). Lipid metabolism, important life-style parameters (food and physical activity) and a knowledge of important laboratory tests (glucose and creatinine) also changed positively. Antihypertensive medication remained nearly unchanged during the period of observation.

CONCLUSIONS

The patients participating in the Health Program Hypertension were already reasonably well controlled. The program achieved further lasting improvement of blood pressure. In addition the participants were motivated to adopt a more health-conscious life style. Training and care of the patients by a medical services centre would seem sensible and successful. But it remains a challenge, especially to reach poorly controlled hypertensives and to motivate them to an active participation in the program.