[Problems in secondary prevention of arterial hypertension in primary health care system].

AIM

Assessment of the quality of follow-up of patients with arterial hypertension (AH) within the framework of primary health care system.

MATERIALS AND METHODS

A retrospective analysis of outpatient case histories of 927 patients with AH treated at 6 health centers in the city of Kemerovo in 1995-1996 was carried out. A special table was created in order to assess the quality of follow up. This table included all data on the follow-up.

RESULTS

The study revealed an insufficient volume of examinations of target organs over the latest two years: total analysis of the urine was carried out in only 572 patients, total cholesterol measured in 228, the fundus oculi examined in 384, and ECG performed in 615 patients; echoCG of the heart and major vessels was carried out in only 111 patients and loading tests in 24. Antihypertensive therapy was administered to 758 patients; only 216 of these took drugs regularly, 163 used none at all, and 543 patients took drugs only during exacerbations of disease. Very often they used ineffective drugs longer used now and caused numerous side effects: clofelin, adelphan, rauwolphine, dibasole, papaverine, magnesium sulfate.

CONCLUSION

The quality of follow-up of patients with AH does not meet the modern requirements to follow-up due to various causes: 1) social neglect of patients; 2) physicians neglect modern recommendations on the diagnosis and treatment of AH; 3) physicians' efforts are not aimed at the prevention of disease complications, prolongation of the life span of patients, and improvement of the quality of their life; 4) patients are not ready to active treatment.