What is the clinical evidence from this study?

Study design: Observational. Population: Hypertension (n=154). Intervention: Nonsmoker status vs. Current smoker status. Primary outcome: Hypertension control (<140/90 mm Hg) (OR 4.36, 95% CI 1.22-15.51, p=0.02).

What does this research mean for the field?

Nonsmoker status, private insurance, increased number of medications, and patient awareness of their blood pressure goals and control status are independently associated with hypertension control, whereas race/ethnicity is not. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 5, 2010Open Access

Predictors of Hypertension Control in a Diverse General Cardiology Practice

Q: What are the key findings of this study?

Nonsmoker status (OR 4.36), private insurance (OR 3.40), and increased number of medications (OR 1.32) were independently associated with hypertension control in a diverse general cardiology practice.

Q: What does this research mean for the field?

Nonsmoker status, private insurance, increased number of medications, and patient awareness of their blood pressure goals and control status are independently associated with hypertension control, whereas race/ethnicity is not. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

ADAdam D. DeVoreHeart Failure / Cardiomyopathy MSMatthew J. SorrentinoUniversity of Chicago MAMorton F. ArnsdorfNewYork–Presbyterian Hospital

Key Result

Nonsmoker status (OR 4.36), private insurance (OR 3.40), and increased number of medications (OR 1.32) were independently associated with hypertension control in a diverse general cardiology practice.

Study Design

Type

Observational (n=154)

Multicenter

Structured PICO

Population

154 participants presenting to a diverse, general cardiology practice at a tertiary care center in the United States, of which 121 (78.6%) had hypertension.

Outcome

Hypertension control, defined as <140/90 mm Hgsurrogate

Private insurance, nonsmoker status, number of medications, and patient knowledge of BP goals are significant predictors of hypertension control in a general cardiology practice, while race/ethnicity is not.

Main Result

Effect estimate: OR 4.36 (95% CI 1.22-15.51)

p-value: p=0.02

Limitations

Studied patients in a single cardiology practice, so findings may not be generalizable to other settings
Some survey questions were not previously validated in research studies
Small sample size may have lacked power to detect differences in hypertension control for all assessed variables

Abstract

Factors influencing hypertension (HTN) control in the United States are not well understood. The authors utilized a newly designed survey instrument to interview patients presenting to a diverse, general cardiology practice at a tertiary care center in order to identify factors associated with HTN control. The study was completed in 154 participants, and 121 (78.6%) had HTN. Of those, 111 (91.7%) had awareness of HTN, and 72 (59.5%) had HTN control, defined as <140/90 mm Hg. In a multivariate analysis, race/ethnicity was not associated with HTN control, but private insurance (odds ratio OR 3.40, 95% confidence interval CI 1.25-9.28), nonsmoker status (OR 4.36, CI 1.22-15.51), and number of medications used (OR 1.32, CI 1.12-1.56) were associated with HTN control. Correct recognition of systolic blood pressure goal and knowledge of one's current state of HTN control were also associated with control. In conclusion, in a general cardiology practice where patients had a high degree of healthcare access, race/ethnicity was not associated with HTN control, while type of insurance, nonsmoker status, and increased number of medications used were associated. In addition, 2 novel predictors of HTN control, recognition of systolic blood pressure goal and knowledge of HTN control, were identified that can be utilized in creating new HTN treatment interventions.

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