Hypertension Management and Control in Primary Care: A Study of 20 Practices in 14 States

• Published in: Pharmacotherapy 2004-04, Vol.24 (4), p.500-507
• Main Authors: Ornstein, Steven M., Nietert, Paul J., Dickerson, Lori M.
• Format: Article
• Language: English
• Subjects: Adult; Antihypertensive Agents - classification; Antihypertensive Agents - therapeutic use; antihypertensive therapy; blood pressure monitoring; Comorbidity; Female; Humans; hypertension; Hypertension - diagnosis; Hypertension - drug therapy; Male; Middle Aged; Practice Patterns, Physicians; Primary Health Care; United States
• ISSN: 0277-0008; 1875-9114
• DOI: 10.1592/phco.24.5.500.33359

Study Objective. To describe the management and control of hypertension in primary care practice. Design. Retrospective medical record review. Setting. Twenty primary care practices in 14 states. Patients. Thirteen thousand forty‐seven patients with hypertension. Measurements and Main Results. Diagnoses, drugs prescribed, and blood pressure readings were extracted from the electronic medical record at each practice in the study. For patients with hypertension and comorbid diagnoses, the most recent blood pressure and antihypertensive drugs prescribed were determined. Analyses assessed the blood pressure control rates and the association between control and demographic variables, frequency of visits to the practice site, and pharmacologic treatment patterns. Among the 20 practices in the study, 13,047 patients had received a diagnosis of hypertension and their blood pressures had been measured within the previous 12 months. One third of the patients had comorbid coronary heart disease, diabetes mellitus, heart failure, and/or renal insufficiency. The most recent blood pressure reading was below 140/90 in half the patients. Control was associated with age 60 years or younger, female sex, more than one visit to the practice, more than one comorbidity, and type of practice (p