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Predictors of uncontrolled hypertension in ambulatory patients

E L Knight1, R L Bohn, P S Wang

  • 1Division of Pharmacoepidemiology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Hypertension (Dallas, Tex. : 1979)
|October 20, 2001
PubMed

Insights

Poor blood pressure control affects many hypertensive patients. Factors like older age, multiple medications, and lack of patient knowledge contribute to uncontrolled hypertension, suggesting areas for targeted interventions.

Area of Science:

  • Cardiology
  • Public Health
  • Pharmacology

Background:

  • Hypertension management in the U.S. faces significant challenges.
  • Understanding patient characteristics and treatment factors is crucial for improving control.

Purpose of the Study:

  • To identify patient characteristics and treatment factors associated with uncontrolled hypertension.
  • To explore predictors of poor blood pressure control in a diverse patient cohort.

Main Methods:

  • Prospective study of 525 hypertensive patients across 3 healthcare systems over 1 year.
  • Collected data on antihypertensive medication, comorbidities, blood pressure, and patient interviews.
  • Utilized ordinal logistic regression to identify predictors of poor blood pressure control.

Main Results:

  • Only 39% of patients achieved target blood pressure (<140/90 mm Hg).
  • Independent predictors of poor control included older age, multi-drug regimens, low patient knowledge of target SBP, and reported drug side effects.
  • Patients with angina showed a higher likelihood of adequate blood pressure control.

Conclusions:

  • Fewer than 40% of treated patients achieved optimal blood pressure control.
  • Patient-related factors significantly predict poor hypertension control and may be modifiable.
  • Targeted interventions for high-risk patients are needed to improve hypertension management.

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