Uncontrolled blood pressure among hypertensive older adult patients in family practice settings: The contribution of physician and patient characteristics

Abstract

Objective: To determine the patient and physician characteristics associated with blood pressure control among older hypertensive patients in family practice, the prevalence of hypertension and the percent of hypertensive patients with controlled blood pressure. Methods: A systematic review has been performed of published studies which reported an analysis of the association between patient and physician characteristics and hypertension control; Data collected in a retrospective review of patients' health records in 28 family practices and a questionnaire for the participating family physicians has been analyzed. Hierarchical logistic modeling has been conducted to determine the predictors for blood pressure control. Results: More than half of the patients were hypertensive. Among hypertensive patients, almost half had their blood pressure under control. The predictors for good blood pressure control were male gender, presence of cardiovascular disease or nephropathy, less than five blood pressure readings/year and young age of the physician. Diabetes predicted poor blood pressure control. Conclusion: Although blood pressure control has improved considerably, more than half of hypertensive patients remain poorly controlled. Selected patient characteristics and physician practice behavior and characteristics were predictors of the blood pressure control.