Objective: The high risk hypertensive patients have increased mortality. Hospitalizations and mortality is greater in regional areas. Therefore, there is a need to improve understanding of their management at the regional level.
Our objectives were to study the high risk hypertensive patients admitted in a regional Australian Hospital (Ballarat Base Hospital) to help enhance quality of care and decrease mortality in the future.
Methods: High risk was defined as per the National Heart Foundation Australia Guidelines. A random sampling was performed utilizing medical records. Demographics, clinical data and medication management were assessed. 152 hypertensive patients were identified from 2,578 hospital separations for a month.
Results: 48% of the 152 hypertensive patients were classified as high risk. 31.1% of these patients achieved the target BP. 16% were found to have co-morbidities of hypertension (HT), chronic kidney disease (CKD) and diabetes (DM). Other unaccompanied morbidities patients presented with were DM (50%), CAD (44.8%), living alone (37.8%), CKD (20.3%), currently smoking (12.2%).10.8% achieved glycemic control ( however, HbA1c measurements were done in only 21.6% of patients within the last six months). An ACE inhibitor is the most commonly used antihypertensive agent. Women performed better than males in achieving the target BP (16.2% versus 14.9%).
Conclusions: There is an under treatment of HT. HbA1c monitoring is inadequate in most patients.
Early detection, achieving target BP, and optimally treating co-morbidities should remain as priority areas in regional hospitals.