Hypertension Detection and Compliance: Permanent Site Hypertensive Evaluation—A New Method of Increasing Patient Compliance

Abstract

Screening is successful in detecting hypertension, but reducing morbidity and mortality depends on achieving patient compliance. Cardiovascular disease has declined significantly since the thiazide diuretics have become generally available and provided effective and safe treatment of hypertension. More people are now aware of their blood pressure, and more hypertensive people are under treatment than ever before. Unfortunately many are not being treated— or if treated, they are not receiving adequate therapy.

After several years of experimentation in screening, the concept of per manent site hypertension evaluation with an automatic recording device was instituted in a pharmacy. Detection during the first year in 926 people revealed that 51 % were hypertensives. There were 17% with mild hypertension, 9% with moderate hypertension, and 25% under treatment. Those under treatment were assumed to be hypertensive—normal being considered 140/90, and hyperten sive 160/100. Those between were considered mild hypertensives. After the second year, 1726 people had been screened and hypertension was detected in 48%; 18% had mild hypertension, 10% had more severe hypertension, and 20% were being treated.

Compliance was measured in two groups of patients. Short-term compliance (up to 6 months) was measured in 441 patient revisits: initially 16% were normotensive, but on revisit after 6 months, 37% were normotensive—a reduc tion in mild hypertension from 52% to 33%. Long-term compliance (6 months to 2 years) was measured in 402 patient revisits: initially 19% were normotensive, and on revisit 32%—an increase in compliance with a reduction from 48% to 35% in mild hypertension.

A new method, permanent site hypertension evaluation with patient revisits, is suggested as a new way of increasing patient compliance. The presence of normotension is assumed to mean compliance. The easy availability of per manent sites may induce the patient to return regularly, or the patient may be testing the medication or his physician. Whatever the case, normotension is the aim of compliance.