FOLLOW-UP OF A GROUP TREATMENT FOR OBESE ESSENTIAL HYPERTENSIVES IN A PRIMARY CARE SETTING

Discussions on Hypertension is a standardized group program for pharmacologically treated obese essential hypertensives in a primary care setting and aims at reductions of body weight and elevated cholesterol levels, improved compliance and finally a stabilization of blood pressure values with the least possible amount of medication. Since 1983, the program has been conducted by primary care physicians and their staff and was evaluated by our study group. Results include about 3000 patients and indicate an average weight reduction of 5.2 kg with an initial weight of 88.6 kg, a blood pressure reduction of 9.3 5.1 mmHg (initial values 153 92 mmHg) in addition to the effects of a pharmacological treatment, and a reduction or a withdrawal of medication in one third of the patients at a 3-month follow-up. A 1-year follow-up investigation with 17 physicians, who conducted the program in 1987 and who agreed to provide follow-up data, indicates an average long-term weight reduction of 5.6 kg in 113 patients and a blood pressure reduction of 11.6 5.1 mmHg compared to the initial values. In 23. 9% of the patients the drug could be withdrawn, and in 19.4% the dose of the drug could be reduced. Nine of these physicians with 54 patients presented data of a 2-year follow-up assessment. Body weight still showed a decrease of 4.9 kg and a reduction of 8.7 6.9 mmHg in blood pressure. Medication was reduced in 44.4% of the subjects. Although this study's results may not represent the whole population, they may indicate what might be achieved in long-term treatment conducted by highly motivated, primary care physicians and their staff. © 1991.