Article - the Republic of Georgia High Blood Pressure Control Program

The Republic of Georgia High Blood Pressure Control Program

V.Y. Barbakadze, MD, PhD; L.G. Koblianidze, MD; N.N. Kipshidze, MD, PhD, FACP, FACC, Professor;

C.E. Grim, BS, MS, MD, PhD, FACP, FACC, FAHS, Professor; C..M. Grim; F. Tavill, MD.

Abstract

Introduction: 52% of adults have uncontrolled hypertension in the Republic of Georgia. We incorporated a blood pressure control program into an existing primary healthcare system in an attempt to improve the rate of blood pressure control.

Methods: We conducted standardized trainings of rural primary care providers - doctors and nurses in accurate measurement of blood pressure according to the Shared Care Method of Training and Certification. Our attention was focused especially on patient management according to the JNC Guidelines. Antihypertensive treatment was implemented by a stepped care approach with Hydrochlorothiazide and Atenolol which was given to patients at follow up visits at no cost. The treatment goal was 140/90 mm Hg based on the office blood pressure.

Results: A total 251 patients with uncontrolled hypertension were enrolled into the Program. 32% of patients had hypertension of stage I, 41% - stage II by JNC VI and 27% – stage III. During the first 30 months follow-up period blood pressure decreased gradually from 170/95 to 140/82 mm Hg. The rate of high blood pressure control increased progressively up to 59%.

Conclusions: We conclude that it is possible to improve hypertension control rate in all groups of patients, even in a health care system possessing very limited resources and based on the existing primary healthcare system. We emphasize that Georgia or any other health care system should not wait for a universal primary health care system to improve the high blood pressure control. It can be incorporated into whatever system exists today.

Key Words: Hypertension, Primary Care, Standardized Training.

Union of Laboratory Diagnostic, National Center of Therapy, Tbilisi, Georgia....