Background The aim of the study was to assess the patient-related reasons of uncontrolled hypertension in the hospital admission department and to analyse the model of treatment.
Material and methods Studied subjects were the patients treated in Admission Department of Internal and Geriatric Clinic because of high level of blood pressure [nNT] in three months period. The control group consisted of the treated hypertensive patients with normal values of blood pressure (BP < 140/90 mm Hg) [kNT]. All patients filled out the questionnaire form. Questions were related to the history of hypertension, taken medicines, level of education, life style habits, over-the-counter medications and compliance with the treatment regimen.
Results The studied group did not differ according to the age (for nNT: 59.2 ± 13.6 years vs. 62.0 ± 11.4 years for kNT) and gender (% men in uncontrolled and controlled hypertensive group: 42.3% and 38.9% respectively). The higher education was more prevalent among controlled hypertensives subjects (27.8%) than in patients with poor control of hypertension (19.2%). The blood pressure values were 179.8 ± 7.1/103.6 ± 6.8 mm Hg for uncontrolled hypertensives and 130.4 ± 7.1/80.9 ± 6.8 mm Hg for control group. The everyday home blood pressure measurements declared 34.0% nNT i 52.9% kNT, and respectively: 85.0% vs. 92.9% of subjects during antihypertensive therapy in 2 weeks before office-visits, declared regular drug taking. Subjects with controlled hypertension were taking more drugs - three and more medications took almost 1/3 of subjects, and only 15% of uncontrolled hypertensives. Uncontrolled patients significantly more frequently owned up to additional salting of meals (nNT: 36.6% vs. kNT: 11.8%). In logistic model of regression the factors which determined a better hypertension control were: everyday home blood pressure measurement, higher education level, professional activity and salt reduction (no additional salting).
Conclusion Better blood pressure control was observed among higher educated patients in spite of similar medicines used in their treatment regimes. Education programs should be aimed especially at lower educated patients and at teaching them proper rules of home blood pressure measurements.