Literature DB >> 18854471

Prehypertension and hypertension in a primary care practice.

Marshall Godwin1, Andrea Pike, Allison Kirby, Carolyn Jewer, Laura Murphy.   

Abstract

OBJECTIVE: To assess the prevalence of prehypertension and the prevalence and treatment of hypertension in a family practice population.
DESIGN: Cross-sectional study.
SETTING: An academic family practice unit. PARTICIPANTS: Practice patients aged 30 to 80 years who had visited the clinic at least once during the 2 years before the study and had at least 1 blood pressure (BP) measurement recorded on their charts during that time period. MAIN OUTCOME MEASURES: Most recent BP recorded on the chart; presence or absence of a diagnosis of hypertension recorded on the chart; number and class of prescribed antihypertensive medications.
RESULTS: Of the 1388 patients who met the inclusion criteria, 389 had a diagnosis of hypertension. Of the 999 who did not have a diagnosis of hypertension, 306 (30.6%) met the criteria for prehypertension used in this study (systolic BP of 130 to 139 mm Hg or diastolic BP of 85 to 89 mm Hg). Men and older patients (60 to 80 years of age) were more likely to have prehypertension than other patients were. Of the patients with hypertension, 254 (65%) had achieved a BP level of < 140/90 mm Hg. The majority of hypertensive patients were prescribed 1 or 2 medications. Only 4.5% were using more than 2 different medications.
CONCLUSION: A large proportion of a family practice's patients need close surveillance of BP because of the prevalence of prehypertension. Despite the improvement in the management of hypertension, only 65% of hypertensive patients had achieved the recommended target BP. Family physicians could be treating their hypertensive patients more aggressively with medications; only 4.4% of patients were using more than 2 different antihypertensive medications, despite 35% not being at target. Hypertension surveillance and treatment to achieve target BP levels continue to be important issues in primary care.

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Year:  2008        PMID: 18854471      PMCID: PMC2567253     

Source DB:  PubMed          Journal:  Can Fam Physician        ISSN: 0008-350X            Impact factor:   3.275


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