Document Detail


Control of blood pressure in North Carolina primary care: baseline data from the GLAD Heart Trial.
MedLine Citation:
PMID:  19256180     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In general, adherence to blood pressure guidelines is low. We assessed whether hypertension recognition and control in North Carolina was consistent with the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) in primary care practices participating in a quality improvement study regarding the implementation of the ATP3 cholesterol management guideline in primary care in North Carolina (GLAD Heart).
METHODS: Demographic and clinical data were abstracted from 5,073 charts (patients aged 21-84 years, seen from June 1, 2001 to May 31, 2003) at 60 practices. Sites were non-university based primary care practices from 22 North Carolina counties. A dyslipidemia screening was defined as a lipid profile performed when not on lipid-lowering therapy. Among patients receiving a lipid profile, the proportion with diagnosed, undiagnosed, and controlled hypertension, was calculated according to JNC 7 guidelines. Practice level hypertension control was examined using the median and interquartile range across practices.
RESULTS: Among 1,763 patients screened for dyslipidemia, 49.4% had diagnosed hypertension. Only 67 individuals (3.8%) had undiagnosed hypertension. Although 85.8% of hypertensive patients were treated, the median proportions of patients with blood pressure below goal (< 140/90, < 130/80 with diabetes) was 33.3% (21.8%-43.7%), with women more likely to be controlled and individuals treated by a solo provider less likely to be controlled.
LIMITATIONS: These data were abstracted from the charts of patients who received a lipid profile; therefore, they are only generalizable to individuals who are screened for hyperlipidemia.
CONCLUSIONS: There remains a need to improve hypertension management in North Carolina primary care among patients screened for hyperlipidemia.
Authors:
Erica L Rosenberger; David C Goff; Cralen C Davis; Caroline S Blackwell; Alain G Bertoni
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  North Carolina medical journal     Volume:  69     ISSN:  0029-2559     ISO Abbreviation:  N C Med J     Publication Date:    2008 Nov-Dec
Date Detail:
Created Date:  2009-03-04     Completed Date:  2009-04-01     Revised Date:  2011-05-25    
Medline Journal Info:
Nlm Unique ID:  2984805R     Medline TA:  N C Med J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  441-6     Citation Subset:  IM    
Affiliation:
Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, USA. erosenbe@wfubmc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Pressure*
Blood Pressure Determination
Demography
Female
Guideline Adherence / statistics & numerical data
Humans
Hyperlipidemias
Hypertension / diagnosis,  drug therapy,  prevention & control*
Male
Middle Aged
North Carolina
Practice Guidelines as Topic
Primary Health Care*
Retrospective Studies
Risk Factors
Grant Support
ID/Acronym/Agency:
R01 HL070742-01/HL/NHLBI NIH HHS; R01 HL070742-02/HL/NHLBI NIH HHS; R01 HL070742-02S1/HL/NHLBI NIH HHS; R01 HL070742-03/HL/NHLBI NIH HHS; R01 HL070742-04/HL/NHLBI NIH HHS; R01 HL070742-05/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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