Extent and predictors of controlled hypertension in low-income, inner-city African Americans with treated hypertension.

摘要

African Americans have a higher prevalence of hypertension and are at increased risk for sequelae of hypertension. To assess the prevalence of controlled hypertension in recent enrollees in a publicly-funded clinic serving an inner-city, low-income African American population, 914 charts were reviewed and those of 219 patients (56 +/- 11 years [mean age +/- SD], 64% female, 100% African American, BMI = 32 +/- 7 kg/m2) were selected for analysis based on modified Health Plan Employer Data and Information Set (HEDIS) 2000 criteria. At the index visit, only 19% had systolic BP < 140 mm Hg, 44% had diastolic BP < 90 mm Hg, and 16% had both. After an average of 2.5 +/- 1.7 years of follow-up, 51% achieved systolic BP < 140 mm Hg, 73% had diastolic BP < 90 mm Hg, and 47% had both (P < 0.0001 for each). There were no significant differences in the mean number of pills prescribed for the controlled and uncontrolled groups (2.5 +/- 1 and 2.7 +/- 1, P = 0.403 by t-test) or in the distribution of drug classes used (P = 0.057 by chi-square). The 3 significant independent predictors of BP control in backwards stepwise logistic regression analysis were BMI < 30 kg/m2 (OR = 2.36, 95% CI: 1.27--4.36, P = 0.006), no non-adherence to medications documented in clinic notes (OR = 6.11, 95% CI: 3.32--11.25, P < 0.0001) and having coronary artery disease (OR 3.36, 95% CI: 1.18--9.56, P = 0.023). These data suggest that hypertension can be controlled in an inner-city, low-income African American population at a prevalence approaching that recommended by Healthy People 2010.