Control of arterial hypertension in a family care unit

OBJECTIVE: To assess the impact of the implementation of the Family Health Care Program for arterial hypertension management in a primary care unit. METHODS: There were studied 135 patients with confirmed diagnosis of arterial hypertension (45 patients from each primary care team) who received treatment between December 2003 and December 2004 and were followed up until July 2005 in the city Salvador, Northeastern Brazil. Blood pressure measures were compared at baseline and at the end of the follow-up period, and their association with cardiovascular risk factors and variables such as gender, age, body mass index, number of medical visits, number of antihypertensive drugs taken by patients, education level and family income were evaluated. Data were described as means and standard deviations, absolute and percentual values and the Wilcoxon, Kruskal-Walis and Chi-square tests were performed. RESULTS: Mean blood pressures at baseline and at the end of the follow-up were 155.9 +/- 24.1/95.3 +/- 13.9 mmHg and 137.2 +/- 16.1/86.7 +/- 8.7 mmHg (p<0.01), respectively. At starting treatment, 28.9% hypertense patients had well-controlled blood pressure levels (<140/90 mmHg) compared to 57% at the end of the follow-up period (p<0.01). The mean number of medical visits was 10.1 +/- 3.9, with 91.8% compliance. Two antihypertensive drugs were used by 50.4% and one drug by 35.6% of the patients. The prevalences of associated risk factors assessed at entering the program were overweight/obesity (71.9%), dyslipidemia (58.5%) and diabetes/impaired fasting glucose (43.7%). The results of the different care teams were comparable. CONCLUSIONS: The implementation of the Family Health Care Program has provided a better management of arterial hypertension but the associated risk factors have remained at higher levels than those recommended and thus needing better management.