Organization and efficacy of an out-patient hypertension clinic.

. A description is given of the diagnostic and therapeutic routines at an out-patient hypertension clinic. The efficiency of treatment in terms of BP control, patient adherence and frequency of side-effects is presented. The patients were derived from a screening examination of a random third of an urban male population aged 47–54 years. Cut-off points for hypertension were BP above 175 (systolic) or 115 (diastolic) mmHg on two separate occasions or current antihypertensive therapy. With these criteria, 11.2% of the population was considered hypertensive. Out of 686 hypertensive men, cared for at the clinic, only 4.2% defaulted during a two-year follow-up. At the second annual examination 83% had casual diastolic BP below 105 mmHg, with an average reduction of 10 mmHg. The antihypertensive therapy consisted of single drugs, a diuretic or a β-adrenergic blocking agent, in 32% of the patients. Fifty per cent of the patients had a combination of two drugs; diuretics and β-adrenergic blockers or β-adrenergic blockers and hydralazine, while 14% had the triple combination of diuretics, β-adrenergic blockers and hydralazine. Side-effects so serious as to cause withdrawal of a drug occurred in 15% of the patients during the first year and in 3% during the second year of antihypertensive therapy.