engleski

Effectiveness of hypertension treatment in family medicine clinics in urban and rural environment in South Croatia

Objective Living conditions of rural and city inhabitants greatly differ. In rural areas there is often less access to medical services, worse transport connections with medical centers, and a lower socio-economic standard. The objective of this study was to compare characteristics and effectiveness of hypertension control in urban and rural environments in South Croatia (Split vs Dalmatian hinterland). Design and Methods A historical cohort study analyzed patients diagnosed with hypertension from 2008 – 2013. From the first time hypertension was diagnosed the patient chart had been followed for 365 days. No. of sick leave days, types and doses of antihypertensive medication, and number of visits to family medicine doctors were compared. Results In total we analyzed 46 patients from Split, and 43 from the Dalmatian hinterland. Although we found sex differences (16 vs. 26 males, P=0.02), and an age difference (M=63 vs M=56, P<0.001) between the patients, we found no differences in the rate of achieving normotension one year following the initial diagnosis (65.2% vs 65.1 %, P=0.83). Patients in both rural and urban areas took a median of 1 medication (most commonly an angiotensin-converting enzyme inhibitor or a diuretic). When we compared patients who did not achieve normotension with those that did, only observed difference was in the initial diastolic pressure (M=97 vs M=93, P=0.04). Conclusion Family physicians in Split and Dalmatian hinterland have a high success rate (65%) of achieving normotension in firstly diagnosed patients one year after the diagnosis. Higher initial diastolic pressure seems to be related to difficulties in achieving normotension. Further studies are needed to determine long term effects of family physician treatment of hypertension, as well as optimal methods for hypertension control.

Hypertension control ; Urban area ; Rural area ; Physicians

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