title: Morehouse Community Physicians Network (CPN) hypertension registry: patterns of care and opportunities for targeted medical education.
abstract: BACKGROUND
  Provider-focused strategies for improving outcomes in hypertension have produced mixed results. Studies suggest that the effectiveness of a chosen strategy increases when it is tailored to the specific situation. The hypertension registry includes data on African-American hypertensives who receive care in community-based primary care settings. We examined the registry to identify patterns of care and opportunities for provider-focused interventions to improve patient outcomes.
  
  
  RESULTS
  The registry will include all records of hypertensive patients from 50 community-based primary care practices at full enrollment. Data from nine practices were manually abstracted into an electronic database and analyzed. Seven hundred and ten records were included in this report. Approximately 70% are female, average age 47 +/- 13 years, 5.3% are uninsured, and more than 60% have at least a high school education. Registry patients have multiple co-morbid conditions: 28% are diabetic, 8% have left ventricular hypertrophy, 5% have congestive heart failure, 6.5% have renal insufficiency, 5% have cerebrovascular disease, 3.5% have previous myocardial infarction and 2% have peripheral vascular disease. Among those with diabetes, mean glycosylated hemoglobin was 7.4 +/- 2. Pattern of antihypertensive use showed 43% on diuretics, 28% on calcium channel blockers, 24% on angiotensin converting enzyme inhibitors, 20% on beta blockers and 16% on angiotensin receptor blockers. Overall, 37% were at goal blood pressure and among those with diabetes, only 16% reached goal blood pressure.
  
  
  CONCLUSIONS
  We conclude that the blood pressure control rates of African Americans in the registry trail those of the general population. This provides a unique opportunity to study the underlying factors and design tailored interventions to address this disparity in health outcome.
authors.affiliation: Division of General Internal Medicine, the Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, Georgia 30310, USA. ighpemp@msm.edu
authors.forename: Priscilla
authors.initials: P
authors.lastname: Igho-Pemu
authors.forename: Alexander
authors.initials: A
authors.lastname: Quarshie
authors.forename: Adefisayo
authors.initials: A
authors.lastname: Oduwole
authors.forename: Rigobert
authors.initials: R
authors.lastname: Lapu-Bula
authors.forename: Robert
authors.initials: R
authors.lastname: Mayberry
authors.forename: Chamberlain
authors.initials: C
authors.lastname: Obialo
authors.forename: Gary H
authors.initials: GH
authors.lastname: Gibbons
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ofili
mesh_terms: D000328:Adult; D001741:Black or African American; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003153:Community Health Services; D015897:Comorbidity; D004501:Education, Medical / Q000458:organization & administration*; D005260:Female; D006123:Group Practice; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000503:physiopathology; D019458:Insurance Coverage; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D012042:Registries; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents