Potential of a registry in evaluation of treatment of patients with essential hypertension in primary care (using the example of polyclinic located in Saratov region)
Aim - to evaluate the quality of treatment among hypertensive patients in workers settlement of Saratovskaya oblast using an research and information system of a registry. Material and Methods - Ambulatory cards of 88 patients with essential hypertension (aged 64.6±11.3 years, males - 40.5%) who visited therapist, general practitioner or cardiologist during one randomly selected day were analyzed retrospectively. To assess the treatment quality we used computer research and informal system of hypertension (Htn), coronary artery disease (CAD) and chronic heart failure (CHF) registry. The registry controls a performance of hypertension guidelines in Htn patients. Results - Patients in the studied group were followed-up according to the guidelines. All patients visited polyclinic no less then four times during the previous year. 42% of patients were administered two or more antihypertensive drugs. However, about one third of hypertensives with uncontrolled blood pressure continued monotherapy. Patients in whom Htn was associated with CAD were prescribed with antiplatelets in 82% of cases, with statins - in 60% of cases and with beta-blockers - in 80% of cases. When Htn were associated with CHF, angiotensin converting enzyme inhibitors (ACE-Is) or angiotensin II receptor blockers (ARBs) were prescribed in 87% of cases. When patients suffered from Htn and atrial fibrillation oral anticoagulants were administered in 62% of cases. Conclusion - Using the Htn, CAD and CHF Registry in primary care unit allows objective evaluation of clinical guidelines performance among Htn patients. It was revealed that combined antihypertensive treatment and separated recommended drugs in case of associated clinical conditions (statins in CAD, anticoagulants in atrial fibrillation) was administered sub optimally. Only half of patients with essential hypertension had their blood pressure controlled.