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Factors Associated With Hypertension Control in the General Population of the United States
Jiang He, MD, PhD;
Paul Muntner, PhD;
Jing Chen, MD, MS;
Edward J. Roccella, PhD, MPH;
Richard H. Streiffer, MD;
Paul K. Whelton, MD, MSc
Arch Intern Med. 2002;162:1051-1058.
Background Uncontrolled hypertension is the most common and important risk factor
for cardiovascular and renal disease. We studied factors associated with hypertension
control in the Third National Health and Nutrition Examination Survey.
Methods A total of 3077 non-Hispanic whites, 1742 non-Hispanic blacks, and 1067
Mexican Americans 18 years or older with hypertension were included in the
current analysis. Blood pressure was measured by trained observers by means
of a standard mercury sphygmomanometer, and controlled hypertension was defined
as a mean systolic/diastolic blood pressure less than 140/90 mm Hg.
Results Percentages of persons with controlled hypertension differed significantly
by ethnicity and sex: 19.2% and 28.7% for white men and women, 17.5% and 28.6%
for black men and women, and 12.7% and 18.0% for Mexican American men and
women, respectively. After adjustment for important covariables, percentages
of persons with controlled hypertension were significantly higher among persons
who were currently (odds ratio [OR] 2.39; 95% confidence interval [CI], 1.52-3.74)
or formerly (OR, 1.81; 95% CI, 1.12-2.93) married, had private health insurance
(OR, 1.59; 95% CI, 1.02-2.49), visited the same facility for their health
care (OR, 2.77; 95% CI, 1.88-4.09) or saw the same provider for their health
care (OR, 2.29; 95% CI, 1.74-3.02), had their blood pressure checked during
the preceding 6 months (OR, 8.00; 95% CI, 3.75-17.1) or 6 to 11 months (OR,
5.31; 2.51-11.2), and reported using lifestyle modification to control their
hypertension (OR, 6.02; 95% CI, 4.20-8.63).
Conclusion These data strongly suggest that access to a regular source of health
care and modification of lifestyle are important factors in the control of
hypertension in the community.
From the Department of Epidemiology, Tulane University School of Public
Health and Tropical Medicine, New Orleans, La (Drs He, Muntner, and Whelton);
Departments of Medicine (Drs He, Chen, and Whelton) and Family and Community
Medicine (Dr Streiffer), Tulane University School of Medicine; and National
Heart, Lung, and Blood Institute, Bethesda, Md (Dr Roccella).
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