P-517: Correlates of hypertension control in a primary care setting

• Published in: American journal of hypertension Vol. 17; no. S1; pp. 222A - 223A
• Main Authors: Majernick, Thomas G., Madden, Nancy A., Zacker, Christopher, Belletti, Daniel A., Arcona, Stephen
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-05-2004
• Subjects: Correlates; Hypertension Control; Primary Care Setting
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/j.amjhyper.2004.03.591

The purpose of this retrospective study is to describe hypertension control and its predictors, using data from a convenience sample of 631 adult patients drawn from an established primary care practice. Data were obtained through retrospective chart review and patient survey during a three month study period. Blood pressure (BP) control, defined as systolic <140mmHg and diastolic <90 mmHg, (subjects with Diabetes Mellitus (DM) SBP < 130mmHg and DBP < 80mmHg), was used as a dichotomous outcome variable in a logistic regression model identifying significant demographic and clinical predictors of control. In our sample, 53% of the cohort were age >64, and 28.5% were age >74. 41% were obese and 80% were overweight. 20% had DM, and 12% impaired fasting glucose (IFG). The mean number of antihypertensive medications used in treatment was 1.8. Patients of low, moderate and high Framingham Risk Score (FRS) were treated with 1.4, 1.6, and 2.3 medications respectively. Women on average received 1.94 drugs verses 1.74 in men. Patients with IFG were treated with an average of 2.0 antihypertensive medications, and patients with DM 2.27. Compared to patients with a low FRS, patients with moderate and high scores had progressively reduced odds of having controlled blood pressure, (69% reduction, 95% CI=0.19, 0.65; 82% reduction, 95% CI=0.10, 0.36, respectively). Being female reduced the odds of achieving BP control by 61% (95% CI=0.26,0.66). Having diabetes (95% CI=0.21, 0.79) or IFG (95% CI=0.10, 0.40) reduced the odds of control by 64% and 82% respectively. For each additional point on a patient knowledge Likert scale, the odds of having controlled BP increased by 78% (95% CI=1.44, 2.56). Each additional comorbid condition positively associated with control, (34% increase in odds, 95% CI=1.15,1.86). Age - odds ratio 0.99 (95% CI=0.98,1.02) and BMI - odds ratio 1.00 (95% CI=0.97,1.04) did not correlate with control. Higher FRS, female gender, DM, and IFG all correlated negatively with control. This is despite the fact that these patients were treated with a seemingly more intensive regimen of drug therapy. Patient knowledge and number of comorbid conditions correlated positively with control. Somewhat suprisingly age and BMI did not correlate with control. These findings may be helpful to primary care providers in their effort to reach BP goals for their patients. Am J Hypertens (2004) 17, 222A–223A; doi: 10.1016/j.amjhyper.2004.03.591