This study involved an audit of the files of patients age 30 - 80 years, in the Memorial University's Family Practice Unit. The resulting database was analyzed to determine: the proportion of people with prehypertension, defined as a systolic blood pressure of 120-139 mm Hg and/or a diastolic 80-89 mm Hg who do not have a diagnosis of hypertension; the differences in prevalence of prehypertension between men and women and by 10-year age groups; the proportion of people with a diagnosis of hypertension; and the number of people with a diagnosis of hypertension whose blood pressure is below 140/90 mm Hg and the average number of anti-hypertensive medications people with hypertension are taking and whether that is related to likelihood of having a blood pressure below 140/90 mmHg.
In a family practice population, we found that 30% of adult patients who do not have a diagnosis of hypertension have prehypertension (130 to 139 mm Hg systolic or 85 to 89 mm Hg diastolic). In patients known to have hypertension, 65% were at target (below 140/90 mm Hg). A large proportion of the population in a family practice need close surveillance of BP levels because of the prevalence of prehypertension. Management of hypertension appears to be better than previously reported, but there remains much room for improvement. Family physicians could be treating their hypertensive patients more aggressively with medications; only 4.4% of patients were using more than 2 different antihypertensive medications, despite 35% not being at target BP levels. Hypertension surveillance and treatment to achieve target BP levels continue to be important issues in primary care.
Published in: Canadian Family Physician, v.58, no.10, October 2008, p. 1418-23