PREVALENCE OF HYPERTENSION AMONG THE PATIENTS WHO ATTEND MEDICINE OUTDOOR OF DHAKA MEDICAL COLLEGE HOSPITAL

Introduction: Worldwide, Hypertension is the established risk factor for many premature cardiovascular morbidity and mortality. Prevalence of hypertension depends on both the racial composition of the population and the criteria used to define the condition and on how extensively the evaluation I done. Objective: To find out the Prevalence of hypertension and also the variation of Prevalence of hypertension, at different age group, rural to urban population, association with other medical conditions and family history of hypertension among the patients who come to seek treatment in Medicine OPD, Dhaka Medical College Hospital. Materials and Methods: This prospective study was carried out in the medicine outdoor of Dhaka Medical College Hospital during the whole month of July’2007. The patients who attend medicine OPD, DMCH during the month of July’2007 to seek medical treatment were included in the study. Exclusion criteria was who denied to measure Blood pressure or non cooperation of the patient. The diagnosis and classification of hypertension was done according to the JNC-7 report. A subject was considered hypertensive if one has an average SBP >140 mm of Hg of DBP>90 mm of Hg or if he/ she was already diagnosed as a hypertensive with or without anti-hypertensive medication. Blood pressure (BP) was measured twice in two arms by using sphygmomanometer. Among the newly detected hypertensive patients, blood pressure was again measured after 15 minutes of rest in handled chair, in calm environment. After second measurement if BP is still more than or equal to 140/90 mmHg, they were detected as hypertensive. After detecting hypertensive patient, their all data are recorded in a structured questionnaire. Results: After proper measurement of BP of 17,792 patiens,t hypertension was found in 554 patient (3.11%) of them 181 were male (32.67%) and 373 were female (67.33%). So, Prevalence of hypertension among the patient who attend medicine outdoor of DMCH is about 3.11% and slight this female predominance. Conclusion: This data may not exactly reflect the actual Prevalence of hypertension as it is outdoor hospital based but give an idea about the Prevalence of hypertension among the patient who attend for treatment in a tertiary based hospital. 1. Resident Physician (RP), Out Patient Department (Medicine), Dhaka Medical College Hospital 2. Medical Officer, Out Patient Department (Medicine), Dhaka Medical College Hospital 3. Post-graduate Trainee, Dept. of Medicine, Dhaka Medical College Hospital Introduction: Cardiovascular disease is a major health problem thought the world and a common cause of premature morbidity and mortality. Hypertension is an established major risk factor and the leading cause of cardiovascular disease worldwide, the rate of hypertension and its complications are decreasing in developed countries whereas it is increasing in developing countries.14 Prevalence of hypertension depends on both the racial composition of the population and the criteria used to define the condition. It also depends on how extensively the evaluation is done.5 Prevalence of hypertension very from country to country, population to population and rural to urban. Prevalence of hypertension increases with age and more common in blacks than in whites.6 Dubey J MEDICINE 2007; 8 : 49-52


Introduction:
Cardiovascular disease is a major health problem thought the world and a common cause of premature morbidity and mortality.2][3][4] Prevalence of hypertension depends on both the racial composition of the population and the criteria used to define the condition.It also depends on how extensively the evaluation is done. 5Prevalence of hypertension very from country to country, population to population and rural to urban.Prevalence of hypertension increases with age and more common in blacks than in whites. 6Dubey VD 7 carried out one of the earliest study in India (1954), documented 4% Prevalence of hypertension (criteria;>160/95) amongst industrial workers of kanpur.In 1984 wasir Hs et al 8 reported 3% Prevalence of hypertension (Criteria :>160/95) in delhi.Another two studies carried out in rural areas of haryana 9 (1994-95) demonstrated 4.5% Prevalence of hypertension (JNC V Criteria).In Europe, the Prevalence of hypertension is as high as 44%, while in US, epidemiological data for the period 1999 -2002 indicated as prevalence of 28.6%. 10,11

Materials and Methods:
The objective of the study to find out Prevalence of hypertension among the patient who attend medicine outdoor of Dhaka medical college hospital.So that we can get an idea about Prevalence of hypertension among the patient who come to seek treatment at a territory based hospital.Other objective is to find out the variation of Prevalence of hypertension at different age group, rural to urban population and also to get a idea about association of other medical conditions among the hypertensive patient and is there any history of hypertension or other medical conditions among the family members of hypertensive patients.This prospective study was carried out in the medicine outdoor of Dhaka Medical College Hospital during the whole month of July'2007.Inclusion criteria for selection of patient was all the patient who attend medicine outdoor of Dhaka Medical College Hospital during the month of July '2007 to seek medical treatment.Exclusion criteria was who denied to measure Blood pressure or non cooperation of the patient.A subject was considered hypertensive if one has an average Systolic Blood Pressure (SBP) e"140 mm of Hg of Diastolic Blood Pressure (DBP) e" 90 mm of Hg or if he/ she was already diagnosed as a hypertensive with or without anti-hypertensive medication.The diagnosis and classification of hypertension was done according to the JNC-7 report. 12lood pressure (BP) was measured twice in two arms by using sphygmomanometer.Among the newly detected hypertensive patients, blood pressure was again measured after 15 minutes of rest in handled chair, in calm environment.After second measurement if BP is still more than or equal to 140/ 90 mmHg, they were detected as hypertensive.After detecting hypertensive patient, their all data are recorded in a structured questionnaire.Regarding family history; 209 patients (55.00%) had history of hypertension in their family members.There is also family history of stroke (CVD), IHD, DM in hypertensive patients, that was found 113(29.73%),41(10.79%)and 17(4.47%)respectively.

Conclusion:
Prevalence of hypertension among the patients who attend medicine outdoor of Dhaka medical college hospital is 3.11% with slight female predominance.Although this data may not exactly reflect the actual Prevalence of hypertension as it is outdoor hospital based, but give a idea about the Prevalence of hypertension among the patient who attend for treatment in a tertiary based hospital.So, for proper evaluation of Prevalence of hypertension need extensive study in both outdoor-indoor of different hospital and in community.

Table - III
Age distribution of Hypertensive patient (n -554).

Table - II
Type of Hypertensive patient.