Objective: To assess the outpatient treatment of hypertensive patients seen in an emergency department in the throes of a hypertension crisis.
Method: One hundred patients suffering from a hypertension crisis seen at the cardiological emergency sector of Oswaldo Cruz University Hospital, University of Pernambuco, were selected. Data were collected on the diagnosis of systemic arterial hypertension (SAH), drug and nondrug treatment (low-sodium diet, low-calorie diet, regular physical exercise and no smoking). Weight, height and tension levels were measured.
Results: Seventy-one (78%) patients were taking antihypertensives. Of these, 38 (53.5%) were regarded as complying with drug treatment. The systolic, diastolic and mean blood pressure levels of the compliers (187.5, 103.8 and 131.7 mmHg) on admission were similar to those of the noncompliers (p=0.76, 0.63 and 0.36). The majority (38/3.5%) were taking only one antihypertensive to control their tension levels. Among the compliers, the increase in the number of antihypertensives did not reduce the rate of compliance. There were no differences relating to gender, age, race or body mass index between the compliers and noncompliers. The compliers had been diagnosed with SAH for longer than the noncompliers (p=0.01). In 22 (30.9%) patients the dosage of the antihypertensives was considered inappropriate. With regard to nondrug treatment, 72% of the patients were on a low-sodium diet, 18% on a low-calorie diet, 79% did regular physical exercise and 79% were nonsmokers. Only 2% of the subjects practised all four measures and 44% practised two of the four. The individuals complying with more than two of the nondrug measures were older (p=0.038) and had been diagnosed with SAH longer (p=0.002) than those complying with up to two.
Conclusions: The majority of the individuals in the present study seen in the throes of a hypertension crisis were taking a single drug to control their tension levels and showed a low compliance with drug or nondrug treatment for their SAH, while a significant proportion of them were taking their medication in inappropriate doses. The hypertensives who had been diagnosed the longest were the ones who complied most assiduously with the treatment.