title: Establishment of a Difficult Hypertension Clinic in Whangarei, New Zealand: the first 18 months.
abstract: A Difficult Hypertension Clinic was established at Whangarei Hospital (Whangarei, Northland, New Zealand) in March 2006 in response to a perceived need amongst general practitioners. The experience with the first 150 patients is reviewed. Mean BP at referral was 162/89 mmHg, and mean number of antihypertensive drugs was 2.49. Mean BP at discharge from the Difficult Hypertension Clinic was 138/78 mmHg and mean number of antihypertensive drugs 3.16. The commonest cause of hypertension resistance was underprescription of diuretics. Secondary or contributory causes of hypertension were identified in 28 (19%) of patients, and white coat hypertension in three (2%). The Difficult Hypertension Clinic established in our hospital is an effective model for achieving clinical targets and care recommended in evidence-based guidelines.
authors.affiliation: Whangarei Hospital, Whangarei, Northland, New Zealand. waltervdm@ihug.co.nz
authors.forename: Walter
authors.initials: W
authors.lastname: van der Merwe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000145:classification* / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents