Analysis of hypertension patients admitted to Internal Medicine Clinics of Abant İzzet Baysal University

Introduction and Purpose: Hypertension is one of the most important health problems. Hypertension affects approximately one billion people worldwide. It is a reversible and most common risk factor for morbidities such as myocardial infarction, stroke, heart failure, atrial fibrillation, aortic dissection, and peripheral artery disease. The aim of this study conducted in Abant Izzet Baysal University Medical Faculty Internal Medicine Clinic is to analyze the general characteristics of hypertensive patients whom followed up in our clinic. We also aimed to determine the effect of factors such as awareness of the disease, compliance with antihypertensive treatment, observing the treatment targets, regular follow-up on hypertension control. Expressing data to improve control rates of hypertension, an important public health problem was also aimed. Materials and Methods: Hypertension patients admitted to Abant Izzet Baysal University Medical Faculty Medical Practice and Research Hospital Internal Medicine Department between 01.01.2016 and 30.06.2016 was enrolled to this study. According to blood pressure levels below 150 mmHg systolic and 90 mmHg diastolic in patients over 60 years old were considered as regulated hypertension. In patients under 60 years of age, blood pressure values below 140 mmHg systolic and 90 mmHg diastolic blood pressure were considered as on target. Results: Our study included 342 patients. Of these patients, 127 were male and 215 were female. The mean age of the patients with normal blood pressure was 63±11.3 years and the mean age of the patients with high blood pressure was 61.5±10.4 years. The systolic blood pressure of the patients in the regular hypertensive and uncontrolled hypertension groups were 130 (90-148) mmHg and 153 (124-201) mmHg, respectively. As expected, there was a statistically significant difference between the groups in terms of systolic blood pessure (p<0.001). Similarly, the diastolic blood pressure of regulated hypertension group (75±8.49 mmHg) was significantly lower than the uncontrolled patients (84±10.6 mmHg), (p<0.001). The body mass index value of the patients with normal and elevated blood pressure were 30.2±5.1 kg/m2 and 31.5±6.4 kg/m2, respectively. The difference was statistically significant (p=0.007). When we classified the study group as compliant and noncompliant to the antihypertensive treatment, it was found that the blood pressure regulation ratio was significantly higher in the compliant (62.8%) than in the noncompliant group (46.6%) (p=0.003). Of the patients, 116 (33.9%) knew the normal range of blood pressure and 226 (66.1%) did not know. There was a significant difference in terms of blood pressure regulation between the group who knew the normal range of blood pressure and the group who did not (p<0.008). The waist circumference of patients whose blood pressure values were regulated was 99.5 (72-143) cm. The waist circumference of unregulated blood pressure values was 104 (76-152) cm. The difference between the groups was statistically significant (p=0.001). Discussion and Conclusion: The most important factors affecting blood pressure regulation were body mass index, waist circumference, regular use of medications and knowledge about normal ranges of blood pressure in our study. The striking result of this single centered retrospective study is that the most important factors for better blood pressure regulation in patients with hypertension are compliance to the treatment and knowledge about the normal ranges of blood pressure. In addition, increased body mass index and waist circumference seem to deteriorate blood pressure regulation. Discussing with the patients about the disease and treatment targets by physicians is important for a better blood pressure regulation, as well as, commitment and ability to understand and application of the interventions of the patients. Keywords: Blood pressure, waist circumference, body mass index