title: The Edgecombe County High Blood Pressure Control Program: the process of medical care and blood pressure control.
abstract: As part of the Edgecombe County High Blood Pressure Control Program, a medical record review was conducted within a multispecialty private group practice in the county. The purposes of the review were to assess the relationship between the process of medical care and blood pressure control and to explore the variation in level and impact of medical care by race and sex. At the end of a three-year period, 41 percent of 628 hypertensive patients from the practice had uncontrolled diastolic blood pressure (DBP), as defined by Hypertension Detection and Follow-up Program criteria. The percentage of uncontrolled hypertensives ranged from 53 percent for black men to 34 percent for white women. Hypertensive patients whose physicians were more aggressive in their use of antihypertensive drug therapy were more likely to be controlled. The effect of the level of physician drug aggressiveness tended to be more pronounced for blacks than for whites. Differences by race in exposure to and efficacy of aggressive drug treatment may influence racial variation in blood pressure control.
authors.affiliation: Department of Medical Statistics and Epidemiology, Mayo Clinic, Rochester, MN 55905.
authors.forename: D J
authors.initials: DJ
authors.lastname: Ballard
authors.forename: D S
authors.initials: DS
authors.lastname: Strogatz
authors.forename: E H
authors.initials: EH
authors.lastname: Wagner
authors.forename: D S
authors.initials: DS
authors.lastname: Siscovick
authors.forename: S A
authors.initials: SA
authors.lastname: James
authors.forename: D G
authors.initials: DG
authors.lastname: Kleinbaum
authors.forename: C A
authors.initials: CA
authors.lastname: Williams
authors.forename: L M
authors.initials: LM
authors.lastname: Cutchin
authors.forename: M A
authors.initials: MA
authors.lastname: Ibrahim
mesh_terms: D000367:Age Factors; D000959:Antihypertensive Agents / Q000627:therapeutic use; D044383:Black People; D001794:Blood Pressure; D002983:Clinical Competence; D005260:Female; D005500:Follow-Up Studies; D006302:Health Services Research; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control*; D008297:Male; D012737:Sex Factors; D044465:White People
chemical_list: D000959:Antihypertensive Agents