Evaluation of the Initial Care of Hypertensive Patients

Patterns of patient care were evaluated retrospectively from the records of 994 patients hospitalized at a university hospital, a community hospital, and two Veterans Administration hospitals. Arterial pressure was not obtained by the admitting physician in 26% of the patients; and in those in whom a blood pressure was recorded, it was elevated in 18%. Of 200 patients discharged with the primary diagnosis of hypertension, the history, physical examination, and diagnostic evaluation were clearly inadequate. Thus, unless physician-recognition and adequate evaluation are improved (through education) the practice of massive public health screening programs seems pointless.