Predictors of Blood Pressure Control in Primary care Patients

Purpose Clinical trial evidence has demonstrated the benefits of blood pressure (BP) lowering in reducing cardiovascular-related morbidity and mortality. Despite this fact, BP control in primary care settings remains poor. The purpose of this study was to evaluate BP control and its predictors in a primary care hypertensive population. Methods Patients with a primary diagnosis for hypertension (ICD-9 401.xx) were randomly selected from medical claims. A retrospective chart review was conducted (n = 506) to obtain demographic, behavioral, and clinical characteristics. Logistic regression techniques were performed to identify predictors of BP control, defined as systolic Results Approximately 55% of the random sample was female with a mean age of 63 ± 14 (SD) years. The mean number of cardiovascular risk factors was 2.7. A majority (61%, n=309) of patients had controlled BP. After controlling for age and gender, having diabetes (n = 99) reduced the odds of achieving BP control by 86% (95% CI 0.08–0.24) when compared to patients with BP control. Patients with poor medication compliance reported in their charts (n = 38) reduced the odds of control by 65% (95% CI 0.17–0.72). Other variables, including race (OR 0.93, 95% CI 0.82–1.05) and BMI (OR 0.96, 95% CI 0.93–1.00), were not significant predictors of BP control. Conclusion BP control in this hypertensive population was higher than previous estimates of 31% (NHANES 1999–2000). Hypertensive patients with diabetes and poor medication compliance are at an increased risk for uncontrolled BP. Identification, education, and more aggressive treatment of this high-risk population may reduce future cardiovascular-related complications and mortality.