Abstract
Hypertension is the most common cause of preventable death in developed countries
and also an important problem in developing countries. The objectives of this study
were to evaluate clinical audits and clinical outcomes of hypertensive treatment compared
with the Thai Hypertension Society guidelines, 2007. The study population included
1,274 patients who were treated in the hypertensive clinic of Thawatchaburi Hospital from October 1, 2006 to September 30, 2007. The results showed that 492 males
(38.62%) and 782 females (61.38%) with a mean age of 64 years 5 months participated in
the study and 83.31 percent of the cases were under the universal health care coverage
system. Only some risk factors associated with hypertension were recorded, ranging
from 2.51 percent to 90.66 percent. Almost all (98.74%) of the patients’ BMI levels were
recorded; 55.57 percent of them had normal BMI. There were several co-morbidities in
the records: 53.14 percent had dyslipidemia and 35.24 percent DM. The prevalence of
nephropathy and left ventricular hypertrophy was 6.59 percent and 3.77 percent, respectively.
One- third of the medical treatments used two categories of hypertensive medicines
and the other third used only one catagory. Diuretics were used in 36.50 percent of
the cases, with 29.75 percent being ACE-inhibitors, 20.15 percent beta blockers and 12.35
percent Ca channel blockers. Follow-up adherence was 76.45 percent; 23.41 percent of
the cases had well-controlled blood pressure whereas only 3.39 percent of those with DM
were well controlled.
In conclusion, a model for the development of hypertensive care should be developed
by all stakeholders, including clinicians, other health-care professionals, patients
and their families in order to improve continuously the quality of care and its outcome.