A survey of hypertensive practices at two community health centres in Cape Town

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dc.contributor.authorRayner, Brian
dc.contributor.authorBlockman, Marc
dc.contributor.authorBaines, Donette
dc.contributor.authorTrinder, Trinder
dc.date.accessioned2016-03-04T13:57:40Z
dc.date.available2016-03-04T13:57:40Z
dc.date.issued2007
dc.date.updated2016-01-11T09:18:49Z
dc.description.abstractBackground: Control of hypertension remains an elusive goal, but doctors' non-compliance with guidelines, patient attitudes and adherence to treatment, and poor delivery of care at clinics are important contributing factors. Objectives: To determine the overall quality of hypertensive care, and compliance with current hypertension guidelines at community health centres (CHCs) in the Western Cape. Methods. Consecutive patients attending hypertension clinics at two CHCs were selected to participate. A questionnaire was designed to determine patient demographics, doctors' compliance with hypertension guidelines, factors leading to treatment non-adherence, and delivery of care. Accuracy of blood pressure (BP) recording was evaluated by comparing the clinic BP with that measured using an approved manometer. Results: One hundred and sixty-one patients were evaluated, 100 from CHC 1 and 61 from CHC 2. There was no difference in both control systolic and diastolic BP measured by the hypertension nurse (147.9 v. 144.8 mmHg, p = 0.45, and 89.3 v. 85.6 mmHg, p = 0.14) respectively. All clinic BP readings were recorded to the nearest 10 mmHg mercury. The difference in both systolic and diastolic BP > 10 mmHg between the clinic and control BP was significantly greater at CHC 2 than CHC 1 (28% v. 56%, p = 0.005, and 43% v. 64%, p = 0.007) respectively. Overall, 39.8% of patients had a systolic and diastolic BP < 140 and < 90 mmHg. The mean number of antihypertensive drugs was 2.4 per patient. The use of non-steroidal antiinflammatory drugs (NSAIDs) and tricyclic antidepressants was high at both centres, and few patients underwent basic investigations, lifestyle interventions, risk stratification or global cardiovascular risk reduction. Conclusions: 39.8% of patients achieved a BP < 140/90 mmHg. There is significant scope for improvement in prescription of medication, application of uniform lifestyle changes, and avoidance of NSAIDs and tricyclic antidepressants. Major deficiencies were identified in BP measurement, assessment of target organ damage, risk stratification and the reduction of overall cardiovascular risk.en_ZA
dc.identifier.apacitationRayner, B., Blockman, M., Baines, D., & Trinder, T. (2007). A survey of hypertensive practices at two community health centres in Cape Town. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/17433en_ZA
dc.identifier.chicagocitationRayner, Brian, Marc Blockman, Donette Baines, and Trinder Trinder "A survey of hypertensive practices at two community health centres in Cape Town." <i>South African Medical Journal</i> (2007) http://hdl.handle.net/11427/17433en_ZA
dc.identifier.citationRayner, B., Blockman, M., Baines, D., & Trinder, Y. (2007). A survey of hypertensive practices at two community health centres in Cape Town: original article. South African Medical Journal, 97(4), 280-284.en_ZA
dc.identifier.issn0256-9574en_ZA
dc.identifier.ris TY - Journal Article AU - Rayner, Brian AU - Blockman, Marc AU - Baines, Donette AU - Trinder, Trinder AB - Background: Control of hypertension remains an elusive goal, but doctors' non-compliance with guidelines, patient attitudes and adherence to treatment, and poor delivery of care at clinics are important contributing factors. Objectives: To determine the overall quality of hypertensive care, and compliance with current hypertension guidelines at community health centres (CHCs) in the Western Cape. Methods. Consecutive patients attending hypertension clinics at two CHCs were selected to participate. A questionnaire was designed to determine patient demographics, doctors' compliance with hypertension guidelines, factors leading to treatment non-adherence, and delivery of care. Accuracy of blood pressure (BP) recording was evaluated by comparing the clinic BP with that measured using an approved manometer. Results: One hundred and sixty-one patients were evaluated, 100 from CHC 1 and 61 from CHC 2. There was no difference in both control systolic and diastolic BP measured by the hypertension nurse (147.9 v. 144.8 mmHg, p = 0.45, and 89.3 v. 85.6 mmHg, p = 0.14) respectively. All clinic BP readings were recorded to the nearest 10 mmHg mercury. The difference in both systolic and diastolic BP > 10 mmHg between the clinic and control BP was significantly greater at CHC 2 than CHC 1 (28% v. 56%, p = 0.005, and 43% v. 64%, p = 0.007) respectively. Overall, 39.8% of patients had a systolic and diastolic BP < 140 and < 90 mmHg. The mean number of antihypertensive drugs was 2.4 per patient. The use of non-steroidal antiinflammatory drugs (NSAIDs) and tricyclic antidepressants was high at both centres, and few patients underwent basic investigations, lifestyle interventions, risk stratification or global cardiovascular risk reduction. Conclusions: 39.8% of patients achieved a BP < 140/90 mmHg. There is significant scope for improvement in prescription of medication, application of uniform lifestyle changes, and avoidance of NSAIDs and tricyclic antidepressants. Major deficiencies were identified in BP measurement, assessment of target organ damage, risk stratification and the reduction of overall cardiovascular risk. DA - 2007 DB - OpenUCT DP - University of Cape Town J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2007 SM - 0256-9574 T1 - A survey of hypertensive practices at two community health centres in Cape Town TI - A survey of hypertensive practices at two community health centres in Cape Town UR - http://hdl.handle.net/11427/17433 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/17433
dc.identifier.vancouvercitationRayner B, Blockman M, Baines D, Trinder T. A survey of hypertensive practices at two community health centres in Cape Town. South African Medical Journal. 2007; http://hdl.handle.net/11427/17433.en_ZA
dc.languageengen_ZA
dc.publisherHealth and Medical Publishing Groupen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.sourceSouth African Medical Journalen_ZA
dc.source.urihttp://www.samj.org.za/
dc.titleA survey of hypertensive practices at two community health centres in Cape Townen_ZA
dc.typeJournal Articleen_ZA
uct.subject.keywordshypertensive practicesen_ZA
uct.subject.keywordscommunity health centresen_ZA
uct.subject.keywordsCape Townen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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