[Results of hypertensive treatment in outpatient hypertension clinics with different payment status].

Background: Arterial hypertension concerns about 40% of adult population in Poland. WOBASZ study shows that vast majority of hypertonics in Poland are treated unsuccessfully. The aim of study was to compare the effectiveness of hypertension treatment by specialist in different payment status outpatient clinics in 2 periods: 1996-2000 (A) and 2001-2006 (B).

Material And Methods: The received data is based on documentation of 1772 patients with essential hypertension (ntp) in three outpatient hypertension clinics: one public-PP and two private outpatient hypertension clinics (NP). Duration of treatment: 2-10 years (average 54 months). Two periods were compared: period A: 1996-2000 (679 patient) and period B: 2001-2006 (1093 patients). Every patient had blood pressure measured twice within approximately 1-2 minute interval in siting position after 15 minute rest. We used mean blood pressure from both measurements in our analysis.

Results: Blood pressure lowering < 140/90 mmHg was reached in location PP with 79% patients in A and with 84.5% patients in period B. Blood pressure lowering < 140/90 mmHg was reached in location NP correspondingly with 99.5% patients and with 99.7% patients. Levels of hypertension were as follows: in P- no patients with hypertension 1.level in period A, 7% in period B while in NP 2.1% and 3.5% correspondingly. There was similar percentage of patients with hypertension 2.level in all clinics. Differences were observed in proportion of treated patients with hypertension 3.level. In NP.- more patients were treated in period B (24.7%) than in period A (10.8%) and more than in P (A: 4.2% B: 1.2%). Patients over 64 years old were mainly treated in PP. Young patients, especially during last five years, were treated in NP.

Conclusions: 1. In public type of clinic the majority of treated patients with essential hypertension were over 64 years of age, in private clinics were in different age. 2. Treatment in private clinics was better than in public in patients with essential hypertension regardless of aging, gender and coexisting diabetes type 2 or complications of hypertension. 3. In public clinic hypertensive treatment during 2001-2006 was more effective than 5 year before but only in group of patients without complica tion hypertensive or coexisting diabetes type 2.