EARLY IMPACT OF AN OUTPATIENT HYPERTENSION CLINIC IN A DISTRICT HOSPITAL

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Objective: Arterial hypertension (HTN) is a major preventable cause of cardiovascular morbidity and mortality. To address this issue, we implemented an outpatient HTN clinic at our hospital, mainly focused on patients with suspected secondary and complex HTN (including HTN associated with oncology treatments, dysautonomy or autoimmune disease). We aim to characterize the patients followed at our clinic and to analyze the effectiveness of this consultation in relation to HTN etiological classification, blood pressure (BP) control and emergency department episodes. Design and method: We designed a retrospective cohort study, concerning all patients who were evaluated in our clinic from June 2022 until December 2023. We excluded patients who abandoned the follow-up after the first evaluation. Results: We evaluated 238 patients with a mean age of 48.3±15.1 years. Although the majority of patients were caucasian (56.8%, n=138), our population is characterized by a significant proportion of patients of african ancestry (36%, n=85). We observed a slightly higher prevalence of resistant HTN in these patients, when compared to other groups (21.8% vs 18.8%). Of the patients who have concluded the etiologic study, a secondary cause of HTN was found in 64.5% (n=80). When evaluating the effectiveness in BP control, we observed that there was a significant reduction in both systolic (mean variation of -14.1±25.4mmHg, p<0.001) and diastolic BP (mean variation of -7.7±16.4mmHg, p<0.001) between the first and last patient evaluations. The proportion of patients with controlled BP improved significantly from 26.9% to 55.6% (p<0.001). Additionally, the emergency department episodes due to hypertension crisis were also significantly reduced after initiating follow-up at the outpatient clinic (mean 0.5±0.6 vs. 0.1±0.4 episodes/patient, before and after follow-up respectively, p<0.001). Conclusions: Monitoring selected patients with HTN in a hospital outpatient setting is an effective way to improve their BP control and to investigate any underlying causes that may require targeted treatment. This approach not only benefits individual health but may also reduce the number of hypertensive crisis admissions in the emergency department, thereby reducing the burden on the health system.