The prevalence of adequate blood pressure (BP) control was investigated in patients with hypertension in a university cardiology or general medicine clinic.
We investigated in 344 women and 257 men with hypertension (27% white, 41% Black, 28% Hispanic, and 4% of other races), mean age 60±16 years, in a university cardiology or general medicine clinic the prevalence of adequate BP control. BP was considered adequately controlled if the last BP was <140/90 mm/Hg and <130/80 mm Hg in patients with diabetes or chronic renal insufficiency.
In 601 patients, 1 antihypertensive drug was used in 202 patients (34%), 2 drugs in 197 patients (33%), 3 drugs in 153 patients (25%), 4 drugs in 40 patients (7%), and 5 drugs in 9 patients (1%). In 601 patients, diuretics were used in 363 patients (60%), beta blockers in 355 patients (59%), angiotensin-converting enzyme inhibitors in 354 patients (59%), angiotensin receptor blockers in 72 patients (12%), calcium channel blockers in 105 patients (17%), and other drugs in 11 patients (2%). BP was adequately controlled in 380 of 601 patients (63%), in 170 of 272 patients (63%) 65 years and older, and in 210 of 329 patients (64%) younger than 65 years (p not significant). BP was adequately controlled in 65% of whites, in 63% of Blacks, in 62% of Hispanics, and in 63% of patients of other races (p not significant). BP was adequately controlled in 336 of 484 Medicaid or private insurance patients (69%) versus 44 of 117 self pay or Medicare patients (38%) paying for their own drugs (p <0.001).
Hypertension was adequately controlled in 38% of patients who had to pay for their antihypertensive drugs versus 69% of patients who received their antihypertensive drugs because they were on Medicaid or had private insurance (p <0.001).
There is a significantly lower incidence of adequate BP control in patients with hypertension who have to pay for antihypertensive drugs prescribed by their physician.
G. Gandelman, None.