Audit conducted in Al-Twar Clinic, Dubai, U. A. E. during January 2012, to identify the level of control and management of hypertensive patients.

1. Audit on Control of
Hypertension in Al-Tawar
Clinic

2. Index
• Introduction
• Aim Of Audit
• Methodology
• PHC Hypertensive Guidelines
• Criteria
• Recommendations

3. Definition:
• Hypertension is the term used to describe high
blood pressure.
• Blood pressure is a measurement of the force
against the walls of your arteries as your heart
pumps blood through your body.

4. Definition:
• Blood pressure readings are usually given as
two numbers -- for example, 120 over 80
(written as 120/80 mmHg). One or both of
these numbers can be too high.
• The top number is called the systolic blood
pressure, and the bottom number is called the
diastolic blood pressure.

5. • Normal blood pressure is when your blood
pressure is lower than 120/80 mmHg most of
the time.
• High blood pressure (hypertension) is when
your blood pressure is 140/90 mmHg or above
most of the time.
Definition:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001502/

6. Definition:
• If your blood pressure numbers are 120/80 or
higher, but below 140/90, it is called pre-
hypertension.
• If you have pre-hypertension, you are more
likely to develop high blood pressure.

7. Epidemiology
• National health surveys in various countries
have shown a high prevalence of poor control of
hypertension.

8. • These studies have reported that prevalence
of hypertension is 22% in Canada, 26.3% in
Egypt, and it is 13.6% in China. Overall,
approximately 20% of the world’s adults are
estimated to have hypertension.

9. • Out of 386 cases admitted in 2006, 147
(38.1%) were Emirati and 61.9% were
Expatriates in the U.A.E, but hypertension
was more prevalent among females in the
age group 45-64 years and males in the age
group 65 years and above.

10. Types of Hypertension:
• I)Primary (essential) hypertension :
For most adults, there is no identifiable cause of
high blood pressure. This type of high blood
pressure, called essential hypertension or
primary hypertension, tends to develop
gradually over many years.

11. • II)Secondary Hypertension:caused by other
medical conditions like:
• Chronic kidney disease
• Disorders of the adrenal gland
(pheochromocytoma or Cushing sydrome)
• Pregnancy (preeclampsia)
• Medications such as birth control pills, diet pills,
some cold medications, and migraine medications
• Narrowed artery that supplies blood to the kidney
(renal artery stenosis)
• Hyperparathyroidism

13. Aim of the audit :
To assess the level of control of blood
pressure among the hypertensive
patients visiting Al-Twar Clinic –
Dubai in January 2012.

14. Methodology
• Audit design:
– Retrospective audit.
• Population :
– Hypertensive Patients attending at Al-Twar Health
Center in January 2012.
– 122 patients visited the health center in January, the
whole population was included in the audit.
– Out of the 122, 4 patients were excluded and with
some files unavailable we ended up with 115 files to
audit.
– Population was obtained from the hypertension
register.

15. • Inclusion and Exclusion Criteria:
– We included All hypertensive patients
attending Al – Twar health clinic in January
2012.
– We excluded any patient diagnosed on
January 2012.

16. Guidelines
1. Blood Pressure for Non-Diabetic
Patients <140/90 mmHg
2. Blood Pressure for Diabetic Patient
<130/80mmHg

17. • Data Collection sheet was set in a table with the
following format:
• Operation definition was developed.
Patient
#
Health
Card #
Gender Nation
ality
D.O.B Age Diabetic Date of
Last BP
reading
Last BP
reading
Conclu-
sion

18. • Pilot study was conducted and data collection
sheet was modified accordingly.
• Data collection was done on October 2012 by
us.

19. Results
Numbers Percentage
Age: Mean: 57.38 -
Max: 84 -
Min: 32 -
Gender: Female: 64 56%
Male: 51 44%
Nationality: Emirates: 109 95%
Other: 6 5%

20. Results
48%
51%
Controlled/Uncontrolled
Controlled
Uncontrolled

21. 35
48
28
12
0
10
20
30
40
50
60
Controlled Uncontrolled
Diabetic
Non-Diabetic

22. Recommendations
Service Improvement:-
• Ensuring that screening and detection of
hypertension is provided in the medical
practice.
• Health education about lifestyle management
to prevent hypertension.
• Monitoring special diseases and conditions,
such as diabetes, congestive heart failure, and
renal dysfunction.

23. Recommendations
• Considering combination therapy for patients
with hypertension
• Encouraging patient, family, and community
activities to promote healthy lifestyles and
blood pressure control

24. Recommendations
For the doctor :-
• All hypertensive patients should be
followed by the same doctor to maintain
continuity of care.
• Special clinic for hypertensive patients

25. Recommendations
For the patient :-
• Patients should follow the instructions
given by the doctor carefully.

26. Causes of Insufficiency
• Workers
• Insufficient/Inconsistent information
• Handwriting

27. Resources
• http://www.omjournal.org/Editorial/FullText/2
00807/ContinuityofCareandQualityofCare.ht
ml
• http://www.businessgrouphealth.org/pub/f2f5
cf61-2354-d714-51f9-0fd930afb424
• www.patient.co.uk › Diseases & Conditions
• http://www.ncbi.nlm.nih.gov/pubmedhealth/P
MH0001502/

28. Thank you for your
listening