Inadequate Management of Blood Pressure in a Hypertensive Population

Abstract

Background Many patients with hypertension have inadequate control of their blood pressure. Improving the treatment of hypertension requires an understanding of the ways in which physicians manage this condition and a means of assessing the efficacy of this care. Methods We examined the care of 800 hypertensive men at five Department of Veterans Affairs sites in New England over a two-year period. Their mean (±SD) age was 65.5±9.1 years, and the average duration of hypertension was 12.6±5.3 years. We used recursive partitioning to assess the probability that antihypertensive therapy would be increased at a given clinic visit using several variables. We then used these predictions to define the intensity of treatment for each patient during the study period, and we examined the associations between the intensity of treatment and the degree of control of blood pressure. Results Approximately 40 percent of the patients had a blood pressure of ≥160/90 mm Hg despite an average of more than six hypertension-rel...