Hypertension in urban Black outpatients. Who gets treated and for how long?

Two-thirds of all Black patients who attended the Medical Outpatient Department of the Johannesburg General Hospital for the first time during May 1975 had recorded diastolic blood pressures of 90 mmHg or above. Almost one-third of all patients were treated for hypertension. About half of the patients with diastolic blood pressures between 90 and 119 mmHg were started on treatment, a decision which was predicted by diastolic blood pressure, recorded symptoms and systolic blood pressure, but not by age. Four of the 50 patients with diastolic blood pressures of 120 mmHg or above were not treated. Less than one-third of all patients started on anti-hypertensive treatment were still returning for treatment at the end of 1 year. There was no difference in initial diastolic blood pressure between those patients who did and those who did not return for treatment. Hospital policies are required for standardizing initial decision-making and long-term treatment of hypertension. Strategies to improve compliance by altering health care delivery and changing patient behaviour must be developed and evaluated.