Predictors of uncontrolled hypertension in ambulatory patients

Hypertension remains poorly controlled in the United States. Improvement of its management will require an understanding of the patient characteristics and treatment factors associated with uncontrolled hypertension. We studied antihypertensive medication use, comorbidity, and blood pressure measure...

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Bibliographic Details
Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 2001-10, Vol.38 (4), p.809-814
Main Authors: KNIGHT, Eric L, BOHN, Rhonda L, WANG, Philip S, GLYNN, Robert J, MOGUN, Helen, AVORN, Jerry
Format: Article
Language:English
Subjects:
Aged
Ambulatory Care Facilities - statistics & numerical data
Antihypertensive Agents - therapeutic use
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Blood Pressure - drug effects
Cardiology. Vascular system
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Female
Follow-Up Studies
Humans
Hypertension - drug therapy
Hypertension - physiopathology
Male
Medical sciences
Middle Aged
Multivariate Analysis
Predictive Value of Tests
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Summary:Hypertension remains poorly controlled in the United States. Improvement of its management will require an understanding of the patient characteristics and treatment factors associated with uncontrolled hypertension. We studied antihypertensive medication use, comorbidity, and blood pressure measurements for 525 hypertensive patients in 3 different healthcare systems over a 1-year period. We concomitantly conducted comprehensive patient interviews covering demographic factors, knowledge of hypertension and its treatment, and medication side effects. Ordinal logistic regression was used to identify factors associated with poor blood pressure control. Mean age of the patients was 65+/-11 years. Mean systolic blood pressure (SBP) was 143+/-15 mm Hg; and mean diastolic blood pressure (DBP), 80+/-9 mm Hg. Only 39% (203/525) of patients had mean blood pressure 160 mm Hgand/or DBP >100 mm Hg). Multivariate analysis revealed several independent predictors of poor control: older age, multi-drug regimens, lack of knowledge by the patient of their target SBP, and a report of antihypertensive drug side effects. Patients with angina had a higher likelihood of adequate blood pressure control. Fewer than 40% of the treated patients studied had a mean blood pressure
ISSN:0194-911X
1524-4563
DOI:10.1161/hy0901.091681