Correlates of controlled hypertension in indigent, inner-city hypertensive patients
Correlates of controlled hypertension in indigent, inner-city hypertensive patients
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DOI：
10.1046/j.1525-1497.1997.12107.x
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发表时间：
1997-01-01
影响因子：
5.7
通讯作者：
Rask, KJ
中科院分区：
文献类型：
--
作者：
Ahluwalia, JS;McNagny, SE;Rask, KJ
目的：在接受治疗的高血压患者中，确定控制高血压的相关因素。设计：病例对照研究。周边环境：市区公立医院。患者：连续的患者样本，他们知道自己的高血压诊断至少1个月，并且以前服用过降压处方。控制患者收缩压(SBP)小于或等于140毫米汞柱,舒张压(菲律宾)小于或等于90毫米汞柱,和SBP患者,180毫米汞柱或类似大于或等于110毫米Hg.MEASUREMENTS和主要结果:对照组的平均血压(BP) 130/80毫米汞柱,例受试者平均BP 193/106毫米汞柱。88年和133年之间的基线人口统计学特征对照组没有显著不同。在logistic回归模型中，在调整了年龄、性别、种族、受教育程度、是否拥有电话和家庭收入等因素后，可控高血压与以下因素相关：定期就诊（比值比[OR] 7.93； 95%可信区间[CI] 3.86, 16.29）、前6个月内看过医生（比值比4.81;1.14,20.31）、报告费用不是购买降压药物的阻碍因素（比值比3.63;1.59,8.28）、有保险（比值比2.15;1.02,4.52）。降压药物治疗方案的依从性具有临界意义（OR 1.96; 0.99, 3.88）。另一项分析发现，与没有医疗保险的患者相比，有医疗补助的患者将费用作为购买抗高血压药物和看医生的障碍的可能性要小得多。结论：在医疗补助计划下，没有自费的药物和医生护理费用可能有助于控制血压。改善所有患者获得常规护理资源的机会和提高对药物费用的敏感性，可能会改善贫困市中心人口的血压控制。
OBJECTIVE: To identify correlates of controlled hypertension in a largely minority population of treated hypertensive patients.DESIGN: Case-control study.SETTING: Urban, public hospital.PATIENTS: A consecutive sample of patients who were aware of their diagnosis of hypertension for at least 1 month and had previously filled an antihypertensive prescription. Control patients had a systolic blood pressure (SBP) less than or equal to 140 mm Hg and diastolic blood pressure (DBP) less than or equal to 90 mm Hg, and case patients had a SBP, 180 mm Hg or DBP greater than or equal to 110 mm Hg.MEASUREMENTS AND MAIN RESULTS: Control subjects had a mean blood pressure (BP) of 130/80 mm Hg and case subjects had a mean BP of 193/106 mm Hg. Baseline demographic characteristics between the 88 case and the 133 control subjects were not significantly different. In a logistic regression model, after adjusting for age, gender, race, education, owning a telephone, and family income, controlled hypertension was associated with having a regular source of care (odds ratio [OR] 7.93; 95% confidence interval [CI] 3.86, 16.29), having been to a doctor in the previous 6 months (OR 4.81; 1.14, 20.31), reporting that cost was not a deterrent to buying their antihypertensive medication (OR 3.63; 1.59, 8.28), and having insurance (OR 2.15; 1.02, 4.52). Being compliant with antihypertensive medication regimens was of borderline significance (OR 1.96; 0.99, 3.88). A secondary analysis found that patients with Medicaid coverage were significantly less Likely than the uninsured to report cost as a barrier to purchasing antihypertensive medications and seeing a physician.CONCLUSIONS: The absence of out-of-pocket expenditures under Medicaid for medications and physician care may contribute significantly to BP control. Improved access to a regular source of care and increased sensitivity to medication costs for all patients may lead to improved BP control in an indigent, inner-city population.