Is blood pressure adequately controlled in general medicine clinics?

To determine how well elderly-essential-hypertensives (EHT) were managed at the general medicine (GM) clinics at Siriraj Hospital when compared to those at the hypertension (HT) clinic. Adequacy of BP management (ADBP) was considered when DBP < 85 mmHg in diabetic patients with HT or < 90 mmHg in non-diabetic EHT. Sixty-seven and 63 cases were enrolled from the GM and HT clinics respectively from mid June to mid July 1999. Percentage of ADBP cases (69.8 vs 49.3%, p = 0.02, OR = 2.4, 95%CI = 1.2-4.9) were significantly higher in patients at the HT-clinic compared to that of the GM-clinic. Physicians' unwillingness to change the number or dosage of drugs when target BP was not achieved was found to be an independent risk factor that contributed to poor BP control of patients from both clinics (p = 0.003, OR = 9.7, 95%CI = 2.2-44.4). In conclusion, the BP of those EHT at GM-clinics was not adequately controlled compared to that of the HT-clinic. Methods to improve normalization of BP were proposed.