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Hypertension control: how well are we doing?

Ann M Borzecki1, Ashley T Wong, Elaine C Hickey

  • 1Department of Health Services, Boston University School of Public Health, Boston, Mass., USA. amb@bu.edu

Archives of Internal Medicine
|December 10, 2003
PubMed
Summary

Blood pressure control improved in hypertensive veterans from 1990-1995 to 1999, especially for those with diabetes and renal disease. However, many patients still had elevated blood pressure, indicating room for improvement.

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Area of Science:

  • Cardiology
  • Hypertension Management
  • Public Health

Background:

  • Hypertension control in military veterans has been previously studied.
  • Treatment practices for hypertension may evolve over time.
  • Comparing historical and recent cohorts can reveal changes in care.

Purpose of the Study:

  • To compare blood pressure (BP) control in a recent cohort of hypertensive military veterans with a previous cohort.
  • To examine changes in hypertension treatment practices, specifically antihypertensive medication dosage adjustments, over time.

Main Methods:

  • Retrospective chart review of 981 hypertensive veterans from 1999.
  • Analysis of BP measurements, comorbidities, and medication use.
  • Comparison with a 1990-1995 cohort of 800 veterans.

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Main Results:

  • Mean BP was significantly lower in 1999 compared to 1990-1995.
  • In 1999, 57% of patients had BP ≥ 140/90 mm Hg, versus 69% in the earlier study (P<.001).
  • BP control improved for patients with diabetes and/or renal disease in the recent cohort.

Conclusions:

  • Overall BP control in hypertensive veterans has improved.
  • Despite improvements, a majority of patients still exceed recommended BP levels.
  • Further improvements in BP management are needed, particularly for patients with diabetes.