Hypertension control in Harare municipal clinics.
Treatment of hypertension is a growing burden on urban health services in Zimbabwe. In 1980, the Harare Health Department began a separate registry, staffed by a nurse, for management of patients with stable hypertension (diastolic blood pressure (DBP less than 100 mmHg) on treatment). We evaluated this programme in a retrospective review of 437 medical records. The average age of patients was 17.5 years; two-thirds were women. Upon referral 324 patients (74 percent) had a DBP less than mmHg. Sixty-five percent of patients had no DBP greater than 100 mmHg during follow-up. Patients with DBP greater than 20 mmHg were more likely to be treated with two drugs, seen more often or referred (p less than 05). One-third of patients enrolled between 1980-1986 were lost to follow-up. Of those who did not default, few attended regularly. We conclude that a nurse can successfully manage patients with stable hypertension, although more aggressive treatment and improved compliance would have resulted in better control. At current levels of loss to follow-up, this programme is unlikely to have much effect on the public health impact of hypertension. The main challenge is to improve patient compliance.
Bassett
T
T
Department of Community Medicine, Avondale, Harare.
Ndoro
E Z
EZ
Mhadzemira
A
A
Mbengeranwa
O L
OL
D003151:Community Health Centers / Q000592:standards*; D003152:Community Health Nursing / Q000592:standards*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D015397:Program Evaluation; D012042:Registries; D012189:Retrospective Studies; D000078329:Workforce; D015030:Zimbabwe