Nadir Ali Mohamed ALI, Joshua GEORGE, Nayan JOSHI, Ming Sheng LIM, Azimuddin Azim SIRAJ. Findings of diabetes eye screening in Brunei Darussalam: REPAS diabetic retinopathy grading scale. Brunei Int Med J. 2015; 11 (4): 182-190

Hypertension management in the Muara Health Centre, Brunei Darussalam

Sajjad KHAN, Ruzanna JOHARI, Mei Chien SEIT

Muara Health Centre, Ministry of Health, Brunei Darussalam

ABSTRACT

Introduction: Hypertension is becoming the major cause of death and disability, even though it is one of the modifiable risk factors for cardiovascular disease (CVD). In Brunei, hypertension is the 2^nd leading cause of outpatient morbidity and the fifth leading cause of death in 2012. The aims of this study was to review the management of hypertension amongst patients based in the Muara Health Centre and to determine whether: 1) CVD risk of patients were assessed, 2) Patients with CVD risk of >20% were offered statin therapy, 3) Patients with treated hypertension had a clinic blood pressure target set to below 140/90 mmHg if aged under 80 years, or below 150/90 mmHg if aged 80 years and over, 4) Patients with resistant hypertension who were receiving four antihypertensive drugs and whose blood pressure remained uncontrolled were referred for specialist assessment. Materials and Methods: Data from 300 patients with hypertension aged between 18 to 80 years old was collected retrospectively from 1^st October to 31^st October 2014. Exclusion criteria included patients with chronic kidney disease, patients from other catchment area, patients discharged from other health centres or physicians’ clinics within a year, patients who had defaulted treatment for more than one year, and pregnant women. Results: Only one (0.3%) patient had CVD risk assessment. Out of the 82 patients with CVD risk of more than 20%, only 55 patients (67.1%) had statin therapy. There were 238 (79.3%) patients with good control of their clinic blood pressures. There were 11 (3.7%) patients who were receiving 4 or more antihypertensive drugs and whose blood pressure were still uncontrolled. However, none of them was referred for further specialist assessment. Conclusion: Management of hypertension is suboptimal; calculation of CVD risk was not being performed or documented as often, patients not started on statin therapy despite their high CVD risk and specialist advice was not sought urgently for patients with resistant hypertension.

Keywords: Hypertension, complication, cardiovascular disease, control, management

Correspondence author: Mei Chien SEIT, Muara Health Centre, Jalan Pelumpong, Muara, Brunei Darussalam. Tel: +673 2770177/ 2770188 E mail: meichien.seit@gmail.com

Brunei Int Med J. 2015; 11 (5): 230-234