TY - JOUR
T1 - Predictors of blood pressure control among hypertensives in community health centers
AU - Shelley, Donna
AU - Tseng, Tuo Yen
AU - Andrews, Howard
AU - Ravenell, Joseph
AU - Wu, Daren
AU - Ferrari, Pamela
AU - Cohen, Asaf
AU - Millery, Mari
AU - Kopal, Helene
N1 - Funding Information:
Acknowledgments:This work was supported by the Agency for Healthcare research and Quality (1r18HS017167-01).
PY - 2011/12
Y1 - 2011/12
N2 - Background The correlates of blood pressure (BP) control among hypertensive individuals who have access to care in community-based health-care settings are poorly characterized, particularly among minority and immigrant populations. Methods Using data extracted from electronic medical records in four federally qualified health centers in New York, we investigated correlates of hypertension (HTN) control in cross-sectional analyses. The sample consisted of adult, nonobstetric patients with a diagnosis of HTN and a clinic visit between June 2007 and October 2008 (n = 2,585). Results Forty-nine percent of hypertensive patients had controlled BP at their last visit. Blacks had a higher prevalence of HTN (B, 32.8%; W, 16.2%; H, 11.5%) and were less likely to have controlled BP (B, 42.2%; W, 50.9%; H, 50.8%) compared with Hispanics and whites. Medication intensification did not differ by race/ethnicity. In multivariate analyses higher body mass index (BMI), black race, diabetes, fewer clinical encounters, and male gender were associated with poor BP control. However, when we applied the Seventh Report of the Joint National Committee (JNC 7) definition for BP control for nondiabetic patients (systolic blood pressure (SBP) <140, diastolic blood pressure (DBP) 90) to all patients with HTN, we found no difference in BP control between those with and without diabetes. Conclusion sBlacks had poorer HTN control compared with whites and Hispanics. Significant discrepancies in BP control between hypertensive patients with and without diabetes may be related to a lack of provider adherence to JNC 7 guidelines that define BP control in this population as <130/80. Further research is needed to understand racial disparities in BP control as well as factors influencing clinician's management of BP among patients with diabetes.
AB - Background The correlates of blood pressure (BP) control among hypertensive individuals who have access to care in community-based health-care settings are poorly characterized, particularly among minority and immigrant populations. Methods Using data extracted from electronic medical records in four federally qualified health centers in New York, we investigated correlates of hypertension (HTN) control in cross-sectional analyses. The sample consisted of adult, nonobstetric patients with a diagnosis of HTN and a clinic visit between June 2007 and October 2008 (n = 2,585). Results Forty-nine percent of hypertensive patients had controlled BP at their last visit. Blacks had a higher prevalence of HTN (B, 32.8%; W, 16.2%; H, 11.5%) and were less likely to have controlled BP (B, 42.2%; W, 50.9%; H, 50.8%) compared with Hispanics and whites. Medication intensification did not differ by race/ethnicity. In multivariate analyses higher body mass index (BMI), black race, diabetes, fewer clinical encounters, and male gender were associated with poor BP control. However, when we applied the Seventh Report of the Joint National Committee (JNC 7) definition for BP control for nondiabetic patients (systolic blood pressure (SBP) <140, diastolic blood pressure (DBP) 90) to all patients with HTN, we found no difference in BP control between those with and without diabetes. Conclusion sBlacks had poorer HTN control compared with whites and Hispanics. Significant discrepancies in BP control between hypertensive patients with and without diabetes may be related to a lack of provider adherence to JNC 7 guidelines that define BP control in this population as <130/80. Further research is needed to understand racial disparities in BP control as well as factors influencing clinician's management of BP among patients with diabetes.
KW - Hispanic
KW - blood pressure
KW - correlates
KW - ethnic minorities
KW - hypertension
KW - low income
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U2 - 10.1038/ajh.2011.154
DO - 10.1038/ajh.2011.154
M3 - Article
C2 - 21866185
AN - SCOPUS:81155150027
SN - 0895-7061
VL - 24
SP - 1318
EP - 1323
JO - American Journal of Hypertension
JF - American Journal of Hypertension
IS - 12
ER -