Presentation on theme: "IS OCCASIONAL CONSULTATION AT A SPECIALIZED HYPERTENSION CLINIC BENEFICIAL FOR CARDIOVASCULAR RISK PROFILE IN HYPERTENSIVES DURING 5-YEAR FOLLOW-UP? M."— Presentation transcript:
IS OCCASIONAL CONSULTATION AT A SPECIALIZED HYPERTENSION CLINIC BENEFICIAL FOR CARDIOVASCULAR RISK PROFILE IN HYPERTENSIVES DURING 5-YEAR FOLLOW-UP? M. Marciniak, K. Słupek, J. Kolbusz, Scientific supervisors: P. Jędrusik, B. Symonides, Z. Gaciong Students' Research Group at the Department of Internal Medicine, Hypertension and Angiology Medical University of Warsaw
OBJECTIVE To assess cardiovascular (CV) risk profile during 5- year follow-up of patients with hypertension (HTN) remaining in the care of family physicians (GPs) and additionally only occasionally attending a specialized HTN day-clinic in our tertiary referral center.
DESIGN & METHODS Studied population n=200 114 women 86 men Mean age: 51,8 ± 14,1 yrs Median HTN duration: 5 yrs Preexisting CV disease - 33% Diabetes mellitus - 13% Proteinuria and/or renal dysfunction- 9%
DESIGN & METHODS Recrutation Patients attending specialized HTN day-clinic in 2000 Single consultation ≤1/year at the request of a GP Follow-up : invitation in 2005 Invitation by mail Phone questionnaire Statistical analysis t-Student test, Chi² – test p<0,05
THE DAY-CLINIC Indications for referral: - Newly diagnosed HTN - Suspicion of secondary HTN - HTN resistant to treatment Frequency of consultations : 1/year / patient
THE DAY-CLINIC Routine evaluation/intervention during visit: –Ambulatory blood pressure monitoring (ABPM) –ECG, routine clinical biochemistry, search for secondary causes of HTN when clinically indicated –Modification of pharmacotherapy –Advice on lifestyle modification
RESULTSP< %31% Current smokers Ns 28.23± ±5.07BMI P< ±2171±15 GFR P= ±17106±24 GLU P< ±31127±34 LDL P= ±1553±14 HDL P= ±66138±89TG P< ±36206±39 CHOL P
AVERAGE NUMBER OF DRUGS TAKEN ,0±1,3/ patient 2005
CONCLUSIONS Even infrequent consultations at a specialized HTN clinic result in improved BP control, lipid levels and lower global CV risk in hypertensives at 5-year follow-up despite advancement in age. No increase in the average number of drugs taken may result from better choice of therapy applied. Such a “backup” for primary care physicians might represent a feasible, possibly relatively low-cost strategy to reduce CV disease burden in general population.