DIPLOMA THESIS TITLE Effectiveness of arterial hypertension treatment in family medicine clinics in urban, rural and island environment in South Croatia: historical prospective study. OBJECTIVES Comparison of characteristics and effectiveness of hypertension control in urban, rural and island environment (Split vs. Dalmatian hinterland vs. southern Croatian islands), in the first year of treatment. We assumed different living conditions – better transport connections and higher socio-economic standard in the city, the geographical isolation of hinterland and islands with less access to medical services and public pharmacies. PATIENTS AND METHODS Data were collected from medical records of 9 family medicine practice by following each patient the same period (365 days) from the visit when hypertension was diagnosed. In case of insufficient medical records, severe acute and chronic diseases or diabetes mellitus, patients were not involved in the study. The primary outcome measures were rates of achieving normotension, mean arterial pressure before and after one-year treatment and complications of treatment. Secondary outcome measures included choice of initial treatment, diagnosis by a physician or a medical specialist, prescribing drugs fully or partially covered by Croatian Health Insurance Fund, length of sick leave and number of visits to physicians. Types of antihypertensive medication, number of daily pills and annual number of drugs per patient were also compared. The research also covered economic aspect of pharmacotherapy. For the statistical analysis of data, the program MedCalc (Mariakerke, Belgium) was used. RESULTS Statistical analysis included a total of 213 patients. A higher proportion of women with hypertension was in urban areas while men led in rural and island areas (64,1 % vs. 57,7 % vs. 54,9 %; P=0,022). Relatively high success rates of achieving normotension one year following the initial diagnosis were found in all three areas (57,8 % vs. 57,7 % vs. 56,3 %; P=0,981). Only diastolic blood pressure differed after one-year treatment (P=0,012). Calcium channel blockers were the most frequently prescribed pharmacotherapeutic group of initial treatment in urban areas (28,6 %) while ACE inhibitors were in rural (28,0 %) and island areas (22,7 %), as well as within observed one-year treatment of the whole sample. Prescribing medications from Croatian list of medications fully or partially covered by Croatian Health Insurance Fund differed among involved physicians (P=0,001). CONCLUSION Urban, rural and island areas of the South Croatia do not differ by rate of achieving normotension in newly diagnosed hypertensive patients after one-year treatment, and it’s relatively high (~57 %). It's higher than other most significant international results. It potentially referrs to more successful regulation of arterial hypertension in Croatia. It's required to raise physicians' awareness about benefits of fixed-drug combinations in order to increase rate of achieving normotension even more. Differences in total annual cost of treating one newly diagnosed hypertensive patient for the Croatian Health Insurance Fund and prescribing preferences among physicians clearly point to necessary national guidelines for the management of arterial hypertension based on the pharmacoeconomic studies.