Search
Close
Search
Advanced Search
Search Menu
AI Discovery Assistant

Abstract

Hypertension control has remained sub-optimal. The Richmond Area High Blood Pressure Center is an independent indigent hypertension specialty clinic that is nurse managed with volunteer physicians, volunteer pharmacist and donated medications. Hypertension control rates were determined for the patients seen within the past 5 years. Using a chart review, patient information was obtained from the last physician visit. Patient demographics, weight, diagnosis of diabetes, creatinine value, presence of dipstick proteinuria, number and types of medication and similar to HEDIS guidelines the last blood pressure was recorded.

869 charts were complete for evaluation. 87% black, 66% female, mean age 55±12 years, mean weight 88±22 kg, 12% diabetic, 24% dipstick positive proteinuria.

Mean systolic blood pressure was 136±15 mmHg, mean diastolic 82±9 mmHg, 82% diastolic BP <90, 63.3% Systolic BP<140, 58.3% <140/90 mmHg. Only 8% of patients with SBP<140 mmHg had a diastolic BP >90 mmHg while 29% controlled for diastolic BP had a systolic >140 mmHg. Uncontrolled patients for systolic were older, while younger had higher diastolic pressure. Weight was higher in the uncontrolled patients.

Although overall control rates were good, only 34% of the diabetics had a BP<135/85. Only 35% of patients with proteinuria had a BP <135/85.

Pulse pressures correlated with systolic blood pressure, lower estimated creatinine clearance and diabetes. Approximately 1/3 of patients had a pulse pressure >60.

85% of patients were on one, two, or three medications. Diuretics were used in 56%, Calcium channel blockers 46%, ACE inhibitor (ACEI) or angiotensin receptor blocker (ARB)in 34%, and 17% were on a beta-blocker. 43% of diabetics were on an ACEI or ARB. 40% of patients with proteinuria were on an ACEI or ARB.

Systolic blood pressure appears to be the most difficult to control correlating with an elevated pulse pressure. Although there is room for improvement, nurse managed clinics with volunteer physicians are capable of achieving better than national averages for blood pressure control particularly in this primarily black and older population.

Free Clinic, Pulse Pressure, Blood Pressure Control
This content is only available as a PDF.
© American Journal of Hypertension, Ltd. 2001
Topic:
Issue Section:
Abstracts
You do not currently have access to this article.
Download all slides