Hypertension control in a rural community. An assessment of community-oriented primary care

To determine the effectiveness of a community-oriented primary care approach for the detection, treatment, and control of hypertension, data were analyzed from a survey of all 3094 adults living in a geographically well-defined rural community. Among the 2939 (96.1%) persons who completed the survey, 587 (20%) were found to meet study criteria for the diagnosis of hypertension. Hypertensive adults who identified a neighborhood health center with a community-oriented primary care philosophy as their source of care were more likely to have their disease detected, treated, and controlled than were hypertensive adults who identified other sources of care. The improved control was most evident for men and for blacks, but in every race-sex stratum, hypertensive patients of the neighborhood health center were more likely to be under control. Even when controlling in logistic models for age, race, and sex, identification of the neighborhood health center was associated with better control of hypertension (beta = 0.591, P = .004). In this rural community, community-oriented primary care delivered through a neighborhood health center appears to be associated with increased likelihood of detection, treatment, and control of hypertension.