Continuity of care in hypertension. An important correlate of blood pressure control among aware hypertensives

Hypertensive patients frequently discontinue follow-up care. In a population-based survey of 4688 adults, we examined the impact of nonattendance on blood pressure control in aware hypertensives. Nonattendance was defined as a failure to visit a physician for hypertensive care within a six-month interval and was reported by 29% of 907 aware hypertensives. Nonattenders had a higher prevalence of diastolic blood pressure above 90 mm Hg (67% vs 30% for attenders). The nonattender profile was male, young, active in the work force, and without coexisting chronic diseases. Poor blood pressure control among nonattenders was associated with a lower treatment rate. Uncontrolled diastolic hypertension and less adherence to medications in nonattenders warrants concern by clinicians.