Continuity of care and hypertension control in a university-based practice

We describe the relationship between continuity of care and control of hypertension.

Retrospective longitudinal cohort study of adults with hypertension.

University of North Carolina Family Medicine Center.

Hypertensive patients making at least four visits to the Center during a two-year period, 1999-2001.

Longitudinal blood pressure level and dichotomous (<140 systolic and <90 systolic) blood pressure control. Independent variables include continuity of care, race and other demographic information, type of primary provider, and insurance type.

Both systolic and diastolic BP fell over the two years (systolic 2.2 mm Hg/year and diastolic 2.8 mm Hg/year). Lower systolic blood pressure was not associated with continuity of care, sex or provider type (faculty vs. resident). Lower diastolic blood pressure had a borderline association with continuity of care (2.2 mm Hg/year, 95% CI -4.7, 0.4). Higher vs. lower continuity of care showed a trend toward better BP control, but the results were not significant (OR 0.84, 95% CI 0.65, 1.09). Lower blood pressures were associated with Caucasian race (vs African American race).

Continuity of care was not related to control of hypertension at our center. The factors related to hypertension control need further research.