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High blood pressure is most commonly treated in the offices of private physicians. We have attempted to evaluate the efficacy of such care through review of all patient charts of a Board Certified, University Medical Center affiliated internist in New York City. Seventeen per cent had elevated (greater than or equal to 160/95) blood pressures or were taking antihypertensive medication at the time of their last visit. A selected group of 206 charts was examined to determine attendance and blood pressure outcome. Over one-half of these patients were lost to follow-up within a year of their initial visit. Of those who persisted in therapy, 55 per cent achieved good blood pressure control. Blood pressure outcomes among medicated patients were not different from those of patients who received no prescription. These results suggest that this conventional pattern of ambulatory medical care, characterized by a high attrition rate and a failure to adequately control blood pressure, may not be suitable to the long-term management of high blood pressure.
Engelland et al. (Mon,) studied this question.