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Abstract

Blood pressure control in the United States is suboptimal. Several surveys in our clinic between 1998 and 2001 showed the prevalence of blood pressure control (≤140/90 mm Hg) between 68-72%. We attempted to identify characteristics of our population that were predictors for controlled blood pressure that might explain these observed differences.

Randomly selected charts of 165 patients (average age 57 +/-14 years, 56% male, 63% white, 63% with a family history) were abstracted. Comparisons were made using Stata 5.0 between the group that achieved blood pressure control (n=107) and those who did not. Blood pressures were taken in a standardized fashion, supervised by the same physician (hypertension specialists) at each visit. The age-adjusted odds ratio (OR) and 95% confidence intervals (95% CI) were calculated for the following characteristics: age (OR=0.99, 95% CI: 0.97-1.01), gender (n=73 females, OR =1.27, 95% CI: 0.66-2.48), race (n=104 white, OR=0.70, 95% CI: 0.36-1.34), family history (n=104, OR=1.86, 95% CI: 0.99-3.61), no weight change (n=17, OR=1.42, 95% CI: 0.40-5.1), weight gain compared to weight loss (n=148, OR= 0.68, 95% CI: 0.33-1.34).

Thus gender, family history, race and weight change were not significant predictors of controlled hypertension. The only factor that was significant was the initial systolic blood pressure, which showed a p-value for trend < 0.002 across the quartiles.

These data suggest that the only characteristic that significantly predicted blood pressure control in our clinic was the initial systolic blood pressure, in agreement with previous work. Aside from this finding, there were no characteristics in our population that could be identified that would explain why we obtain higher blood pressure control rates compared to the general population (see Table).

Initial SBP (mm Hg) n OR (95% CI) 
<149 42 1.00 (0.98–1.03) 
149–160 41 0.61 (0.20–1.81) 
161–178 43 0.25 (0.09–0.69) 
>178 39 0.15 (0.05–0.43) 
Initial SBP (mm Hg) n OR (95% CI) 
<149 42 1.00 (0.98–1.03) 
149–160 41 0.61 (0.20–1.81) 
161–178 43 0.25 (0.09–0.69) 
>178 39 0.15 (0.05–0.43) 

Initial SBP (mm Hg) n OR (95% CI) 
<149 42 1.00 (0.98–1.03) 
149–160 41 0.61 (0.20–1.81) 
161–178 43 0.25 (0.09–0.69) 
>178 39 0.15 (0.05–0.43) 
Initial SBP (mm Hg) n OR (95% CI) 
<149 42 1.00 (0.98–1.03) 
149–160 41 0.61 (0.20–1.81) 
161–178 43 0.25 (0.09–0.69) 
>178 39 0.15 (0.05–0.43) 

Risk Factors, Hypertension Control, Hypertension Specialist
© 2003 by the American Journal of Hypertension, Ltd.
American Journal of Hypertension, Ltd.
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