Hypertension in Harare hospital out-patients: drugs prescribed, drugs taken and control achieved.

Abstract

Patient-retained records supplemented by patieni interviews were used to evaluate hypertension management at Harare Hospital. One hundred and one successive hypertensive out-patients were studied. In over a third of patients diagnosis had been established during medical examination fa an unrelated problem. Only one third of 431 recorded 'on treatment' diastolic blood pressures were less than 100 mm Hg, and one fifth were greater than 119 mm Hg. Thiazides, Methl-dopa and Reserpine were the most commonly prescribed antihypertensives. A step-wise approach to management was evident where two drugs were used, but the choice of a third a fourth drug showed great variation. Thirty percent of patients identified a daily regimen that was different from their recorded prescription. Identification of dosage lower than that prescribed correlated with poor control. Better practitioner-patient interaction and stricter adherence to defined regimens are needed to improve blood pressure control. Patient-retained records can provide useful information for health service evaluation in developing countries.