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Published on: May 17, 2024
[Factors associated with uncontrolled hypertension]
Oliva Mejía-Rodríguez1, Ramón Paniagua-Sierra, María del Refugio Valencia-Ortiz
1Instituto Mexicano del Seguro Social, Morelia, Michoacán, México. oliva.mejia@imss.gob.mx
Insights
Uncontrolled hypertension is linked to patient factors like age and BMI, and healthcare system elements such as physician experience and treatment timing. Optimizing these can improve hypertension management.
Area of Science:
- Primary Care Medicine
- Cardiology
- Public Health
Context:
- Hypertension management in primary care settings is crucial for cardiovascular health.
- Understanding factors influencing hypertension control is essential for effective treatment strategies.
Purpose:
- To evaluate healthcare characteristics associated with uncontrolled hypertension in a primary care outpatient clinic.
- To identify patient, physician, and clinic-level factors contributing to suboptimal hypertension control.
Summary:
- A cross-sectional study reviewed 4040 patient files to identify associations with uncontrolled hypertension.
- Key factors identified include patient demographics (age, BMI), clinical markers (creatinine), medication complexity, physician experience, and treatment timing (morning shift).
Impact:
- Findings highlight the importance of both patient-specific and healthcare system factors in hypertension control.
- Results can inform targeted interventions to improve hypertension management in primary care settings.
Objective:
To assess health care characteristics for hypertensive patients and their association with uncontrolled hypertension in a primary care outpatient clinic.
Design:
Cross-sectional.A review was conducted of 50% of 8080 (n= 4040) files. Patient, physician and primary health care clinic characteristics were recorded.
Results:
The factors associated with uncontrolled hypertension were: age (OR, 1.43; CI95% : 1.015-1.030), BMI (OR, 1.03; CI95%: 1.02-1.05), creatinine serum levels (OR, 1.16; CI95%: 1.03-1.30), three or more different antihypertensive drugs (OR, 1.48; CI95%: 1.31-1.07), to be treated by a physician with more than 20 years of medical practice (OR, 1.21; CI95%; 1.06-1.39) or by a non-specialist physician (OR, 1.43; CI95%: 1.20-1.71) and to be treated in the morning shift (OR, 1.21; CI95%: 1.07- 1.56).
Conclusions:
Hypertension is well-controlled in the majority of patients. Patient-related factors are important in uncontrolled hypertension; however, health care system characteristics also play an important role.
Related Concept Videos
Factors affecting Blood pressure
Physiological Factors:
Hypertension and Regulation of Blood Pressure
Hypertension I: Introduction
Hypertension II: Pathophysiology
Hypertension III: Clinical Manifestations and Diagnostic Studies
Hypertension IV: Drug Therapy and Lifestyle Modifications