Factors predictive of attendance at clinic and blood pressure control in hypertensive patients.

Abstract

Poor compliance with appointments and drug treatment is one of the recognised factors preventing effective management of hypertension. Factors predictive of poor attendance and inadequate blood pressure control in patients attending a hypertension clinic were therefore determined using univariate analyses and a multivariate logistic model. Out of 1346 patients with blood pressure exceeding 160/95 mm Hg followed up for three years, 209 (15.5%) dropped out during the first year. Variables that were significantly related to increased drop out rates were male sex, young age, obesity at entry, cigarette smoking, direct referral to the clinic as a result of screening instead of referral by a general practitioner, absence of pre-existing antihypertensive treatment at the first visit, moderate hypertension, and low socioeconomic category. Variables at entry that were significantly related to poor blood pressure control at one year were old age, evidence of coronary heart disease, severe hypertension, and raised blood glucose concentrations. Early detection of patients at high risk of drop out or poor blood pressure control might improve treatment of hypertension and allow management to be more individually adapted to each patient.