Twenty-one-year survival of primary hypertensive patients allocated to care in general practice or in specialized hypertension clinic. An observational study of 831 hypertensive patients.
After initial diagnostic and therapeutic assessment at a specialized hypertension clinic, 831 patients with primary hypertension were during a 15-year period allocated to continuing care management either by their general practitioner or by the out-patient department of the hypertension clinic. At a given date survival was assessed in the two groups: general practice (n = 437, 233 males, 214 females) and specialized hypertension clinic (n = 394, 208 males, 186 females). Median observation time for both groups was 11 years, the longest observation time was 21 years, 8 months. There were no significant differences between the groups concerning age at entry, pretreatment clinical status, pretreatment blood pressure or treated blood pressure level before allocation. The patients in the two groups had the same access to hospitalization when needed. Judged by a Cox regression model, no difference in survival between the two groups could be registered. No differences were found between the causes of death in the two treatment groups, the main cause of death in both groups being ischaemic heart disease. Our results indicate that after initial diagnostic assessment and adjustment, the management of treatment care in a specialized hypertension clinic offers no advantage concerning survival compared to management of care in general practice.
Strate
M
M
Medical Department C, Odense University Hospital, Denmark.
Vaeth
M
M
Harvald
B
B
D002423:Cause of Death; D005194:Family Practice; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality / Q000628:therapy*; D008297:Male; D008511:Medicine; D008875:Middle Aged; D009026:Mortality; D010044:Outpatient Clinics, Hospital; D013038:Specialization; D016019:Survival Analysis