[Control of blood pressure in a population of patients with hypertension and in a subgroup with hypertension and diabetes: relationship with characteristics of the health care center and the community].
OBJECTIVE
To evaluate how well blood pressure (BP) is controlled in the population of persons with hypertension alone and with diabetes, and to evaluate the influence of characteristics of the health care center on the degree of control of BP. Design. Descriptive, cross-sectional, multicenter, retrospective study.


METHODS
31 health centers in Catalonia (Northeastern Spain). Participants. Random sample of 2240 clinical records of patients with hypertension who were seen at 31 different primary care centers in Catalonia between January and December 1996.


METHODS
Audit of clinical records. We recorded the two most recent BP measurements, and annotations regarding screening for and diagnosis of other cardiovascular risk factors. We also recorded health center and physician characteristics.


RESULTS
495 patients (22.1%) had diabetes in addition to hypertension. 61.2% were women. Mean age was 64.9 years (95% CI, 64.4-65.4 years). In 25.7% of the patients, BP was below 140/90 mmHg (95% CI, 23.9-27.5%), but among patients with diabetes only 6.7% had BP below 130/85 mmHg (95% CI, 4.5-8.9%). Mean systolic and diastolic BP at the end of the study period were higher at teaching centers. Diastolic BP was significantly higher at urban centers and in patients younger than 65 years. Diastolic BP was also higher in patients with at least one associated cardiovascular risk factor, and at centers less than 6 years old, although these differences were not statistically significant. We found no differences according to physician characteristics.


CONCLUSIONS
Blood pressure was adequately controlled in few patients with hypertension and diabetes in Catalonia. Associated cardiovascular risk factors, age less than 65 years, and being a patient at a teaching center or an urban center, were associated with a worse degree of BP control.
Benítez
M
M
Codina
N
N
Dalfó
A
A
Vila
M A
MA
Escribà
J M
JM
Senar
E
E
Miracle
M
M
Tovillas
F J
FJ
D000368:Aged; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D005260:Female; D006268:Health Facilities; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D013030:Spain
Control de la presión arterial en la población hipertensa y en el subgrupo de hipertensos y diabéticos: relación con las características del centro y de la comunidad.