ASSESSMENT OF HYPERTENSION MANAGEMENT IN A PRIMARY HEALTH-CARE CENTER(ARIANA-TUNIS)

The management of hypertensive outpatients in a primary health care ce nter raises problems of follow-up and effectiveness. This study attemp ts to assess the management of high blood pressure, using the Medical Audit method, essentially. For that purpose, 194 medical records of hy pertensive outpatients registered between 1980 and 1986 were studied. More than 80 % of these patients were women between the ages of 40 and 70 years. The medical records of these patients were compared to a st andard management scale including 68 items devised by cardiologists an d general practitioners. Globally, 32 % of the items were respected du ring management of the outpatients. The initial check-up was the least followed item (6.9 %), but afterwards care of patients improved, givi ng ratings of: 29 % for respect of treatment protocol, and 35 % for su rveillance of treatment. As concerns treatment effectiveness, only 28 % of the patients (n = 36) actually completed the five-year follow-up period. In these patients average blood pressure fell from 193 to 143 mmHg (systolic), and from 113 to 93 mmHg (diastolic), between the begi nning of monitoring and the end of the fifth year. The insufficiency o f high blood pressure management results not only from a shortage of r esources, but also from underuse of existing ones, and the practitione rs' lack of information.