BMJ  2004;328:641 (13 March), doi:10.1136/bmj.328.7440.641-b

Letter

Follow up of hypertension by family practitioners

Technique should be taught at school

The first 150 words of the full text of this article appear below.

EDITOR—In a randomised equivalence trial over three years Birtwhistle et al tried to minimise care for essential hypertension if possible.1 Was it satisfactory to monitor blood pressures every six months rather than every three months?

The incomprehensible outcomes were three. The first was where blood pressure was measured, in doctors' premises or patients' homes by nurses. The second considered patients' satisfaction. There is no criterion by which ordinary patients are in any position to know if they ought to be satisfied. The third was adherence to treatment, which is crucially fundamental to any outcome. Twenty per cent of the time patients may not take their pills (and presumably do not need them) but are considered properly treated.

If essential hypertension causes stroke or coronary thrombosis then care is all there is on offer. Death in this group of 600 might be quite rare over three years. We are . . . [Full text of this article]

David Barnes, retired general practitioner

Whites Farm Cottage, Widford, Hertfordshire SG12 8RE mpbrnsres@tinyonline.co.uk


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Relevant Article

Randomised equivalence trial comparing three month and six month follow up of patients with hypertension by family practitioners
Richard V Birtwhistle, Marshall S Godwin, M Dianne Delva, R Ian Casson, Miu Lam, Susan E MacDonald, Rachelle Seguin, and Lucia Rühland
BMJ 2004 328: 204. [Abstract] [Full Text] [PDF]

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