Predictors of Blood Pressure Control Among Hypertensives in Community Health Centers

• Published in: American journal of hypertension 2011-12, Vol.24 (12), p.1318-1323
• Main Authors: Shelley, Donna, Tseng, Tuo-Yen, Andrews, Howard, Ravenell, Joseph, Wu, Daren, Ferrari, Pamela, Cohen, Asaf, Millery, Mari, Kopal, Helene
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Black or African American; Black People - statistics & numerical data; Blood and lymphatic vessels; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Community Health Centers - statistics & numerical data; Cross-Sectional Studies; Female; Health Status Disparities; Hispanic or Latino - statistics & numerical data; Humans; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - epidemiology; Male; Medical sciences; Middle Aged; New York - epidemiology; Prevalence; White People - statistics & numerical data
• ISSN: 0895-7061; 1941-7225; 1879-1905; 1941-7225
• DOI: 10.1038/ajh.2011.154

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)