Actual problems of hypertension care in an ambulatory center from Targu Mures

Written by Preg Zoltán, Kikeli Pál István, Germán Salló Márta, László Mihály Imre, Hubatsch Mihaela, Borbély Mónika oh.

Objective: To determine the actual problems of hypertension management according to ESC 2007 guidelines for the management of arterial hypertension in a prevention profiled ambulatory model. Study design: The study included 6591 hypertensive patients examined between 2002 and 2010 in the Procardia preventive ambulatory centre in Targu Mures, Romania. Sex distribution: 45.64% male, average age 57.45 years, and 54.36% female, average age 61.28 years. Patients received individually tailored self control education, lifestyle advice and drug treatment - the primary care providers were informed in detailed medical reports. We studied the yearly achievement of target blood pressure levels. We also analyzed the frequency of investigations carried out for the global risk assessment and screening for subclinical organ damage. We used “MedPrax” integrated patient data management system as an electronic health record. Results: Target blood pressure values (under 140/90 mmHg in non diabetic patients and 130/90 in diabetic patients) were reached in 29.52%. The percentage of patients treated to target increased progressively from 15.25% in 2002 to 36.29% in 2010. The assessment levels of associated risks were: total cholesterol 66.26%, LDL 39.13%, HDL 41.78%, triglycerides 64.3%, glycaemia 65.62%. The following procedures for subclinical organ damage detection were performed: ECG 90.99%, plasma creatinine 38.01%, echocardiography 22.27%, ankle-brachial index 1.3%, fundoscopy 15.57%. Conclusions: The activity of the studied cardiology ambulatory setting provided a yearly increase in the level of blood pressure target achievement. Further improvement measures are needed to increase blood pressure control rates. More frequent assessment of some subclinical organ damage would be recommended.


Keywords: hypertension, target blood pressure, control rate

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