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Level of hypertension control: comparison of a rural and urban family practice centre in South Croatia

Einstellung der Hypertonie: Vergleich der Ergebnisse in einem Praxiszentrum am Land mit denen einer städtischen Familienpraxis

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Summary

Aim

Arterial hypertension is a serious public health problem because of its frequency and poor management. We compared hypertension control between rural and urban environment over 5 years. Initial hypothesis: arterial pressure control is better in urban (Split) than in rural (Trilj) environment.

Methods

Historic prospective study was conducted in two family medicine outpatient clinics. Data for the years 2005, 2006, and 2010 were analyzed. One hundred and seventeen subjects diagnosed with arterial hypertension in 2005 were examined: 66 in a rural and 51 in urban outpatient clinic. Their average age was 60.92 ± 10.03 (range 30–82 years). Blood pressure records at the onset of the study, the first, and fifth year of treatment, risk factors, and therapy were analyzed. T-test and χ2-test were used in statistical data analysis.

Results

In the urban clinic, more subjects were smokers, had positive family history, were overweight, and had registered hyperlipidemia. Initial mean arterial pressure readings were similar in both the clinics. Decrease was recorded in the following 5 years. During this study the use of ACE inhibitors (ACEI) (Split by 45 %, Trilj by 133 %) and calcium channel blockers (CCB) (Split by 76.9 %, Trilj by 525 %) was increased. The number of patients receiving monotherapy was reduced.

Conclusions

Better arterial pressure control was recorded in the urban clinic, where, after 5 years, despite increased frequency of additional risk factors, the number of normotensive patients was higher than that in the rural one. Hypertension control in both settings was still poor. Hypertensive patients should participate actively in the treatment.

Zusammenfassung

Ziel der Studie

Auf Grund der Häufigkeit und des oft schlechten Managements ist die Hypertonie ein ernstes Problem des öffentlichen Gesundheitswesens. Wir verglichen die Einstellung der Hypertonie über 5 Jahre in einer ländlichen Umgebung mit der einer städtischen. Die anfängliche Hypothese war, dass die Hypertonie- Kontrolle in einer Stadt (Split) besser als am Land (Trilj) sein müsste.

Methodik

In einer historisch-prospektiven Studie wurden die Daten von 2005, 2006 und 2010 zweier Familienpraxen ausgewertet. 117 Patienten (66 aus der ländlichen, 51 aus der städtischen Praxis), bei denen 2005 eine Hypertonie festgestellt worden war, wurden untersucht: das mittlere Alter war 60,92 ± 10,03 (30–82) Jahre. Die RR-Werte vom Beginn der Studie, nach einem Jahr und nach 5 Jahren wurden erhoben. T-Test und χ2-Test wurden zu statistischen Auswertung verwendet.

Ergebnisse

In der städtischen Praxis war die Anzahl der Raucher, der Patienten mit einer positiven Familienanamnese, mit Übergewicht und mit dokumentierter Hyperlipidämie höher. Die initialen RR-Werte waren in beiden Praxen ähnlich. In den folgenden 5 Jahren wurde ein Abfall festgestellt. Während der Studie stieg der Einsatz von ACE-Hemmern (in Split um 45 %, in Trilj um 133 %) und Calciumkanalblocker (in Split um 76,9 %, in Trilj um 525 %). Die Anzahl der Patienten mit Monotherapie wurde reduziert.

Schlussfolgerungen

Die Blutdruckeinstellung war in der städtischen Praxis besser. Nach 5 Jahren war die Zahl der normotensiven Patienten trotz der höheren Häufigkeit von zusätzlichen Risikofaktoren höher als in der Land-Praxis. Die Kontrolle des Hochdrucks war in beiden Praxen noch immer mangelhaft. Patienten mit Hypertonie sollten aktiv an der Behandlung teilnehmen.

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Conflict of interest

The authors declare that there is no actual or potential conflict of interest in relation to this article.

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Authors and Affiliations

  1. Pulmonary Disease Clinic, University Hospital Centre Split, Spinčićeva 1, 21000, Split, Croatia

    Irena Perić MD, PhD

  2. Department of Family Medicine, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia

    Ivančica Pavličević MD, PhD

  3. Vukovarska 127, 21000, Split, Croatia

    Ivančica Pavličević MD, PhD

  4. University Hospital Centre Split, Spinčićeva 1, 21000, Split, Croatia

    Anita Čikara MD

Authors
  1. Anita Čikara MD
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  2. Ivančica Pavličević MD, PhD
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  3. Irena Perić MD, PhD
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Correspondence to Ivančica Pavličević MD, PhD.

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Čikara, A., Pavličević, I. & Perić, I. Level of hypertension control: comparison of a rural and urban family practice centre in South Croatia. Wien Klin Wochenschr 125, 173–179 (2013). https://doi.org/10.1007/s00508-013-0339-x

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