Quality of care in managing hypertension by case finding in north west London.

The records of patients who were registered with general practice in inner London and outer London (both training and non-training practices) were examined for details of blood pressure recordings. A blood pressure recording was found in the past five years in only 22% of the notes of inner London practices but in 43% of notes in outer London practices, there being no difference between training and non-training practices. In 31% of the notes with a blood pressure recording the blood pressure had been raised (greater than or equal to 160/90) at some time: in 62% of these notes for patients aged 65 or more and in 52% of these notes for patients aged under 65 treatment had been given at some time. Thirty eight per cent of patients in the older group and 33% in the younger group were being treated at the time of the survey, thiazides being the most commonly used drugs. Thirty four per cent of all those with a raised blood pressure at some time had a latest recording of under 90 mm Hg diastolic. There seems to be a continuing need for general practitioners to detect and treat hypertension, and it is suggested that general practitioners should consider using systematic case finding for hypertension in their practices.