With chronic non-communicable diseases (NCDs) taking a heavy toll on Barbados’ population and the country’s health care budget, doctors at the University of the West Indies, Cave Hill campus have re-energised medical efforts to tackle the pervasive problem of hypertension, a leading underlying cause of many debilitating and death-inducing illnesses.
On March 1, 2012, UWI personnel reinstituted an ambulatory blood pressure monitoring (ABPM) service at the Queen Elizabeth Hospital which is designed to affect blood pressure monitoring over longer periods, including critical overnight readings, to ascertain more accurate data and implement more effective treatment. Patients who attend the hypertension clinic will undergo near 24-hour monitoring by having the device affixed at 10:00 a.m. on Monday, Wednesday and Friday and removed at 8:00 a.m. on Tuesday, Thursday and Friday.
According to Consultant-in-charge of the clinic, Dr. Kenneth Connell, the more accurate readings from this process, which accords with UK-based National Institute for Health and Clinical Excellence (NICE) protocols should significantly reduce existing treatment for “white coat hypertension” – elevated readings exhibited by patients whose pressure spikes during one-off or periodic readings by medical personnel.
Connell, a lecturer in clinical pharmacology, sees reestablishment of the facility as a major accomplishment not only for improving the QEH’s ability in a critical area of health delivery, but also for enabling the university to demonstrate its mandate of being active in the community.
“The clinic really represents the ideal relationship that has evolved over decades between the QEH and the UWI Faculty of Medical Sciences,” he said. “In fact, as a teaching/research clinic with a UWI Associate Consultant like myself, it allows for the seamless creation of an academic atmosphere for both undergraduate medical students and DM (Internal Medicine) postgraduate doctors. I believe it augurs well for our contribution to patient care and the advancement of knowledge of hypertension and is highly relevant to our society.
According to Dr. Connell the university-serviced clinic caters to patient referrals from both private and public doctors, and also sees hypertensive cases in special groups such as pregnant patients, paediatrics and the elderly.
Acknowledging that persons with NCDs account for over 60 per cent of deaths in Barbados and at least 65 per cent of the budget for the QEH and Barbados Drug Service, Dr. Connell said ABPM is the standard of care for both the diagnosis and management of blood pressure in both the USA and UK and its importance is underlined by the fact that misdiagnosis could lead to over treatment of hypertension resulting in spiralling drug costs.
He added: “The consequences of under treatment are evident; hypertension is a known risk factor for both heart attacks and stroke. In the region, and African Diaspora, there is special interest in hypertension as its aetiology is still not clearly defined. The clinic will serve, therefore, as a practice model for clinical research projects and the implementation of new guidelines for the management of hypertension unique to Barbados and the region.”