The treatment of high blood pressure at the general medical clinic of a traditionally oriented university hospital was found to be unsatisfactory for most patients. Charts of all hypertensive patients (diastolic blood pressure, ≥ 105 mm Hg) who made their first clinic visit in 1964 or 1971 were reviewed. Half of all patients were lost to follow-up within the first year, and blood pressure control was achieved by only one third of the patients. New information contained in the Veterans Administration study reports (1967 and 1970) had no effect on workup, compliance, or blood pressure decline. Furthermore, no significant relationship was found between blood pressure reduction and medical process, therapeutic regimens, or patient compliance. These data suggest that, in contrast to experience obtained in programs specifically designed for long-term management of this chronic disease, the present-day general medical clinic cannot satisfy the needs of most hypertensive patients.
(Arch Intern Med 137:1707-1710, 1977)