title: Predictors of blood pressure control among hypertensives in community health centers.
abstract: BACKGROUND
  The correlates of blood pressure (BP) control among hypertensive individuals who have access to care in community-based health-care settings are poorly characterized, particularly among minority and immigrant populations.
  
  
  METHODS
  Using data extracted from electronic medical records in four federally qualified health centers in New York, we investigated correlates of hypertension (HTN) control in cross-sectional analyses. The sample consisted of adult, nonobstetric patients with a diagnosis of HTN and a clinic visit between June 2007 and October 2008 (n = 2,585).
  
  
  RESULTS
  Forty-nine percent of hypertensive patients had controlled BP at their last visit. Blacks had a higher prevalence of HTN (B, 32.8%; W, 16.2%; H, 11.5%) and were less likely to have controlled BP (B, 42.2%; W, 50.9%; H, 50.8%) compared with Hispanics and whites. Medication intensification did not differ by race/ethnicity. In multivariate analyses higher body mass index (BMI), black race, diabetes, fewer clinical encounters, and male gender were associated with poor BP control. However, when we applied the Seventh Report of the Joint National Committee (JNC 7) definition for BP control for nondiabetic patients (systolic blood pressure (SBP) <140, diastolic blood pressure (DBP) <90) to all patients with HTN, we found no difference in BP control between those with and without diabetes.
  
  
  CONCLUSIONS
  Blacks had poorer HTN control compared with whites and Hispanics. Significant discrepancies in BP control between hypertensive patients with and without diabetes may be related to a lack of provider adherence to JNC 7 guidelines that define BP control in this population as <130/80. Further research is needed to understand racial disparities in BP control as well as factors influencing clinician's management of BP among patients with diabetes.
authors.affiliation: Division of General Internal Medicine, New York University School of Medicine, New York, NY, USA. ds186@nyu.edu
authors.forename: Donna
authors.initials: D
authors.lastname: Shelley
authors.forename: Tuo-Yen
authors.initials: TY
authors.lastname: Tseng
authors.forename: Howard
authors.initials: H
authors.lastname: Andrews
authors.forename: Joseph
authors.initials: J
authors.lastname: Ravenell
authors.forename: Daren
authors.initials: D
authors.lastname: Wu
authors.forename: Pamela
authors.initials: P
authors.lastname: Ferrari
authors.forename: Asaf
authors.initials: A
authors.lastname: Cohen
authors.forename: Mari
authors.initials: M
authors.lastname: Millery
authors.forename: Helene
authors.initials: H
authors.lastname: Kopal
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D044383:Black People / Q000706:statistics & numerical data; D003151:Community Health Centers / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
chemical_list: D000959:Antihypertensive Agents