EVALUATION OF THE EFFECTIVENESS OF ARTERI AL-HYPERTENSION CONTROL IN A PRIMARY HEALTH UNIT

The present study is part of a performance evaluation of the Aging Hea lth Cave Program carried out at a Primary Health Care Clinic. Activiti es for Arterial Hypertension (AH), control oriented accorging to a ris k assessment, in conformity with Ministry of Health norms, are include d in the Program mentioned. The effectiveness of the reduction of bloo d pressure (BP) levels in hypertensive individuals subjected to progra mmatic activities for disease control, in an attempt to identify condi tions associated with that reduction, is evaluated Of the 396 patients with AH registered under the Program between 01/01/92 and 06/30/93, 2 50 cases, were included for this evaluation. These patients had, in ad dition to high blood pressure levels (BP greater than or equal to 160/ 95 mm Hg) on the first attendances at the health center (before regist ration in the programme), at least two medical consultations during pr ogram follow-up. The differences in blood pressure levels between meas urements taken during consultations before the beginning of attendance at the program and those taken on the first attendances to the progra mme, were analysed according to initial blood pressure level, age, sex , registering diagnosis and absences during the program follow-up. Red uctions of greater than or equal to 5 mm Hg in diastolic blood pressur e (DBP) and/or greater than or equal to 10 mm Hg in systolic blood pre ssure (SBP) were obtained in 197 (78.8%) patients. The mean reduction was 8.8 mm Hg (sd = 11.4) for DBP and 17.7 mm Hg (sd = 18.6) for SBP. Results of several epidemiological studies allow the inference that a decrease in the mortality risk from Cardiovascular Disease can be achi eved in a significant proportion of the individuals registered in the program. Blood pressure normalization according to program norms occur red in 111 (44.4%) individuals. Multiple linear regression analysis de monstrated that initial blood pressure and percentages of absenteeism during the follow-rep were independently associated with the reduction s in SEP and DBP. Age was independently associated only with the reduc tions in SEP. Participation of age and percentage of absenteeism durin g the follow-up thus reveal that the final result of the programmed wo rk is also a result of the different ways people take care of their ow n health.