Optimizing the treatment of hypertension in the primary care setting.

OBJECTIVE To assess the result of the care provided by an interdisciplinary team on the control of hypertension. METHODS In a Health Unit, 88 patients were treated by an interdisciplinary team for 12 months. Visits to the physician or nurse occurred every one to three months, and to the nutritionist whenever necessary. Educational lectures were delivered regularly. Total cholesterol and fasting plasma glucose levels were determined at baseline and at 12 months. Clinical and laboratory data were analyzed and blood pressure was compared at baseline and at six and 12 months, and total cholesterol and plasma glucose were compared at baseline and at 12 months. RESULTS Females accounted for 79.41% of the sample and the mean age was 58+/-9.90 years. Median blood pressure (BP) was 166.00/96.5 mmHg at baseline, 146.75/85.25 mmHg at 6 months (p<0,000) and 134.00/80.00 mmHg at 12 months (p<0.000). The rate of BP< or =140/90 mmHg increased from 10.23% to 48.81% (p<0.000). Median total cholesterol decreased from 217 mg/dl to 194.00 mg/dl (p<0.004) and median blood glucose from 101 mg/dl to 95 mg/dl (NS). At baseline, 50% of the patients received two antihypertensive drugs, 25% received three, and 5.68% received four, whereas at 12 months these percentages were 21.18%, 29.41% and 32.94%, respectively. CONCLUSION The care provided by an interdisciplinary team may significantly improve the control of hypertension and of associated cardiovascular risk factors.