Article Figures & Data
Figures
- Figure 1.
Probability of hypertensive patients at each practice having uncontrolled blood pressure at their most recent primary care visit. Information taken from electronic health records of all patients with ≥1 primary care visit over 2 years. Model adjusted for patient age, sex, race/ethnicity, insurance, obesity, smoking status, preferred language, number of primary care visits, and presence of comorbidities (cardiovascular disease, diabetes mellitus and chronic kidney disease). Error bars represent 95% CIs (n = 51,417). The vertical axis shows proportion of patients with hypertension, and the horizontal axis shows data for clinics within each health system. CI, confidential interval; Clin, Clinic.
Tables
- Table 1.
Descriptive Characteristics of Patients with Hypertension in Three Health Systems
Characteristic Health System 1, n (%) Health System 2, n (%) Health System 3, n (%) Total, n (%) n 17,923 13,937 21,273 53,133 Age categories 18 to 39 years 851 (5) 1,072 (8) 2,024 (10) 3,847 (7) 40 to 59 years 7,264 (41) 4,926 (35) 10,514 (49) 22,704 (43) 60 to 85 years 9,808 (55) 7,939 (57) 8,743 (41) 26,482 (50) Female sex 8,880 (50) 7,317 (53) 12,076 (57) 28,273 (53) Race/ethnicity Non-Latino White 3,214 (18) 5,848 (42) 6,197 (29) 15,250 (30) African-American 4,118 (23) 1,838 (13) 5,088 (24) 11,044 (21) Latino 3,113 (17) 1047 (8) 4,581 (22) 8,741 (17) Asian/Pacific Islander 5,976 (33) 3,807(27) 4,420 (21) 14,203 (27) American Indian or Alaska Native 302 (2) 24 (0) 132 (1) 458 (1) Other or unknown 1,200 (7) 1,373 (10) 855 (4) 3,428 (6) Preferred language English 10,560 (59) 11,661 (84) 15,376 (72) 3,7597 (71) Spanish 2,569 (14) 356 (3) 2,916 (14) 5,841 (11) Chinese 2,832 (16) 823 (6) 264 (1) 3,919 (7) Other* 1,911 (11) 1,097 (8) 2,714 (13) 5,722 (11) Insurance Commercial 1,241 (7) 6,815 (49) 6,117(29) 14,173 (27) Medicaid or local county coverage 10,701 (60) 2,179 (16) 10,252 (48) 23,132 (44) Medicare 5,177 (29) 4,782 (34) 3,826 (18) 13,785 (26) No health coverage 804 (4.5) 161 (1.2) 1,078 (5.1) 2,043 (8) Body mass index in kg/m2 Less than 25 4,705 (26) 4,327 (31) 3,787 (18) 12,819 (24) 25 to less than 30 5,832 (33) 4,794 (34) 6,181 (29) 16,807 (32) 30 or greater 6,803 (38) 4,638 (33) 10,475 (49) 21,916 (41) Current smoker 3,811 (21) 996 (10) 4,457 (21) 9,264 (19) Comorbidities Chronic kidney disease 2,246 (13) 1,845 (13) 2,943 (9) 6,023 (11) Diabetes mellitus 6,207 (35) 4,111 (30) 7,803 (37) 18,121 (34) Cardiovascular disease 3,399 (19) 2,620 (19) 2,350 (11) 8,369 (16) Number of primary care visits during 2-year period 1 to 2 visits 2,493 (14) 1,385 (10) 2,250 (11) 6,128 (12) 3 to 4 visits 3,191 (18) 1,705 (12) 2,791 (13) 7,687 (14) 5 or more 12,153 (68) 10,847 (78) 16,232 (76) 39,232 (74) Blood pressure not controlled at last visit 5,110 (29) 4,337 (31) 9,304 (44) 18,751 (35) Information taken from electronic health records of all patients with ≥1 primary care visit over 2 years.
P-values for all comparisons between systems were < .01 using χ2 tests.
↵* Most frequent other languages were Tagalog (n = 1,070), Vietnamese (n = 840), Russian (n = 673), Punjabi (n = 390), Farsi (n = 247), and Arabic (n = 210).
- Table 2.
Descriptive Characteristics of Patients with Controlled and Uncontrolled Blood Pressure on the Day of their Last Primary Care Visit (n = 53,133)
Characteristic Controlled, n (%) Uncontrolled, n (%) n 34,382 18,751 Age categories 18 to 39 years 2150 (6) 1797 (10) 40 to 59 years 13,520 (39) 9184 (49) 60 to 85 years 18,712 (54) 7770 (41) Female sex 18,529 (54) 9744 (52) Race/ethnicity Non-Latino white 9805 (29) 5454 (29) African-American 6304 (18) 4740 (25) Latino 5595 (16) 3146 (17) Asian/Pacific Islander 10,404 (30) 4257 (23) Native American 316 (1) 142 (1) Other or unknown 1958 (6) 1,012 (5) Language English 23,607 (69) 13,990 (75) Spanish 3842 (11) 1999 (11) Cantonese or Mandarin 3125 (9) 794 (4) Others 3775 (11) 1947 (10) Insurance Insured or other health coverage 33,443 (97) 17,872 (95) No health coverage 1063 (3) 980 (5) Body mass index (kg/m2) Less than 25 8949 (27) 5759 (32) 25 to less than 30 14,411 (43) 7134 (40) 30 or greater 13,353 (40) 8563 (48) Current smoker 5289 (17) 3975 (23) Number of primary care visits during 2-year period 1 to 2 visits 3212 (9) 2916 (16) 3 to 4 visits 4761 (14) 2926 (16) 5 or more visits 26,361 (77) 12,871 (69) Comorbidities Chronic kidney disease 3811 (11) 2212 (12) Diabetes mellitus 11,490 (33) 6631 (35) Cardiovascular disease 5516 (16) 2853 (15) Health system Health System 1 12,813 (37) 5110 (27) Health System 2 9600 (28) 4337 (23) Health System 3 11,969 (35) 9304 (50) Information taken from electronic health records of all patients with ≥1 primary care visit over 2 years.
P-values for all comparisons between controlled and uncontrolled hypertension were < .01 using χ2 tests.
- Table 3.
Multivariate Model of Risk of Uncontrolled Blood Pressure at the Most Recent Primary Care Visit
Characteristic Risk Ratio (95% CI) Sex Male (reference) 1.0 Female 0.98 (0.96 to 1.01) Age/Comorbidity category* Aged >60 years with no comorbidities (reference) 1.0 Aged > 60 years with comorbidities 1.64 (1.57 to 1.71) Aged <60 years with no comorbidities 1.72 (1.65 to 1.79) Aged <60 years with comorbidities 1.51 (1.45 to 1.58) Race/ethnicity Non-Latino white (reference) 1.0 African American 1.13 (1.09 to 1.16) Latino 1.01 (0.96 to 1.05) Asian/Pacific Islander 0.95 (0.91 to 0.98) American Indian, other, or unknown 0.99 (0.93 to 1.04) Preferred language English (reference) 1.0 Spanish 0.97 (0.92 to 1.02) Cantonese or Mandarin 0.79 (0.73 to 0.85) Other language 1.05 (1.01 to 1.10) Insurance status No health coverage (reference) 1.0 Insured or other health coverage 0.87 (0.83 to 0.92) Smoking status Never or past smoker (reference) 1.0 Current smoker 1.12 (1.08 to 1.15) Body mass index (BMI) Not overweight or obese (BMI<25 kg/m2) (reference) 1.0 Overweight (BMI 25 to <30 kg/m2) 1.02 (0.99 to 1.06) Obese (BMI > 30 kg/m2) 1.09 (1.06 to 1.13) Number of primary care visits over 2-year period 1 to 2 visits (reference) 1.0 3 to 4 visits 0.85 (0.82 to 0.88) 5 or more visits 0.71 (0.69 to 0.73) Health System Health System 1 (reference) 1.0 Health System 2 1.15 (1.11 to 1.19) Health System 3 1.46 (1.42 to 1.50) BMI, body mass index; CI, confidential interval.
Only patients with complete data were included (n = 51,417).
Statistically significant risk ratio differences in comparison to reference variables are displayed in bold type.
↵* Comorbidities relevant to blood pressure target chronic kidney disease, diabetes, ans cardiovascular disease.
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