Abstract

ABSTRACT: The blood pressure of 60 indigent hypertensive patients who were being treated in the general medicine clinic of a large state-run hospital was found to be unacceptably high after an average follow-up period of 107.5 months. Intensive treatment through a subspecialty clinic resulted in significant decreases in both the mean systolic pressure (from 176.2 to 144.9 mm Hg) and diastolic pressure (from 101.6 to 88.0 mm Hg). Improved blood pressure levels continued for as long as the patients were seen in the subspecialty clinic, but improvement was not maintained at an average of 17.1 months after discharge to the medicine clinic. The mean systolic and diastolic pressures were significantly higher at this time (161.2 and 94.4 mm Hg respectively). We conclude that treatment in a large medicine clinic is inefficient for hypertensive patients and that a subspecialty clinic format is much more successful.