Hypertension control in a rural biracial community: successes and failures of primary care.

Through a total community survey and a medical record review, we examined hypertension awareness, treatment, and control in a biracial rural community rich in primary care resources. The overall prevalence of hypertension among the 2,939 respondents was 20.5 per cent; 82 per cent of hypertensives were aware of their condition; 68 per cent were on treatment; and 55 per cent were under control. Comparison of data sources revealed discrepancies and misconceptions about diagnosis and treatment. Nearly one-third of the population reported a history of hypertension despite the fact that most of them were untreated and were normotensive. Conversely, one-third of "undetected" hypertensives had notation of the diagnosis in their medical records. Discontinuation of treatment accounted for over one-half of aware but untreated hypertension. Misconceptions about therapy contributed to failures of control in the treated group. These findings suggest that difficulties in the transmission of information about hypertension contribute importantly to failures of control.