Process versus outcome in hypertension: a positive result.

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Abstract
The association between the outcome of antihypertensive care and 3 items of that care was studied among 230 hypertensive steelworkers who were referred to 83 physicians. The 1st item was the decision to treat some patients but not others; 63% of the patients were prescribed antihypertensive drugs and the mean decrease in their diastolic blood pressure (DBP) was greater than that among untreated patients (12.2 .+-. 0.84 vs. 7.8 .+-. 0.83 mm Hg [.+-. SEM (standard error of the mean)], P < 0.001). The 2nd item was the vigor of prescribed medication; patients prescribed more vigorous treatments had lower DBP (P < 0.005). The 3rd item, patient compliance, was related to achieving a goal DBP of < 90 mm Hg (P < 0.05) and the product of prescribed vigor and compliance was highly associated with DBP response (P < 0.0001). These results stand in contrast to those of previous studies that failed to detect associations between various other items of the care process and the outcome of antihypertensive care.