title: Physician practice patterns in the treatment of isolated systolic hypertension in a primary care setting.
abstract: The authors evaluated the treatment of isolated systolic hypertension based on medical record review of charts between 1998 and 1999 in a multispecialty physician practice group. Two age-stratified random samples of ambulatory medical records were examined (393 patients aged > or =65 years and 251 patients aged 50-64 years). The samples corresponded to the practices of 35 primary care physicians who were surveyed about their hypertension care. Isolated systolic hypertension was defined as systolic blood pressure > or =140 mm Hg and diastolic blood pressure <90 mm Hg. Results showed that isolated systolic hypertension represented 76% and 45% of uncontrolled blood pressure in the older and middle-aged samples, respectively. Isolated systolic hypertension was often undiagnosed and untreated. Physicians reported treatment thresholds and goals that were significantly less aggressive for their patients > or =65 years of age. Physician awareness and treatment of isolated systolic hypertension have not yet caught up with consensus guidelines, and older patients may be affected most by this gap.
authors.affiliation: Cedars-Sinai Health System, 9100 Wilshire Boulevard, East Tower, Suite 655, Beverly Hills, CA 90212. borenstein@zynx.com
authors.forename: Jeff
authors.initials: J
authors.lastname: Borenstein
authors.forename: Joanna L
authors.initials: JL
authors.lastname: Whyte
authors.forename: Enkhe
authors.initials: E
authors.lastname: Badamgarav
authors.forename: Delia
authors.initials: D
authors.lastname: Vogel
authors.forename: Stephen
authors.initials: S
authors.lastname: Deutsch
authors.forename: Scott
authors.initials: S
authors.lastname: Weingarten
authors.forename: Pablo
authors.initials: P
authors.lastname: Lapuerta
mesh_terms: D000368:Aged; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013599:Systole