• Agbani Ejaife Ono, Erhun Wilson Oyekigho, and Ojo Araoye Adeleke.
• State Primary health care Facility, Ile-Ife, Osun State, Nigeria. agbaefe@yahoo.com
• Sao Paulo Med J. 2006 Mar 2; 124 (2): 105109105-9.

Context And ObjectiveHypertension management and risk prediction based on diastolic blood pressure may be of little value for older people and people with isolated systolic hyper-tension (ISH). This study investigated primary care practice patterns in ISH management in a Nigerian high-risk subpopulation.Design And SettingThree-year retrospective cohort review of outpatient medical records at a state primary health care facility in southwestern Nigeria.MethodsISH was defined according to international guidelines. Treatments were graded as relatively non-aggressive, mildly aggressive and moderately aggressive. Data were collected using a data abstraction form and statistically analyzed.ResultsThe drug/regimen choice controlled systolic blood pressure (SBP) in only 46.90% of the population after the first visit to the clinic. SBP control among treated patients was significantly inadequate. Group mean SBP was consistently > 150 mmHg in 28.13% of the patients for > or = six weeks after enrollment and for at least two additional visits. Data analysis revealed an increasing tendency to place patients on monotherapy or "no drug treatment" with successive visits to the clinic, even in cases of uncontrolled systolic blood pressure, as well as declining prescription of moderately aggressive combination therapy.ConclusionAggressive ISH management needs to be further emphasized at primary care levels, which for many low-income patients may be the first and last orthodox port of call.

18 keywords...

hide…