College of Human Medicine, Michigan State University, East Lansing, MI, USA.
J Clin Hypertens (Greenwich). 2013 Apr;15(4):254-63. doi: 10.1111/jch.12067. Epub 2013 Feb 1.
Hypertension (HTN) is particularly burdensome in low-income groups. Federal-qualified health centers (FQHCs) provide care for low-income and medically underserved populations. To assess the rates and predictors of blood pressure (BP) control in an FQHC in Michigan, a retrospective analysis of all patients with HTN, coronary artery disease, and/or diabetes mellitus (DM) seen between January 2006 and December 2008 was conducted. Of 212 patients identified, 154 had a history of HTN and 122 had DM. BP control was achieved in 38.2% of the entire cohort and in 31.1% of patients with DM. The mean age was lower in patients with controlled BP in both the total population (P=.05) and the DM subgroup (P=.02). A logistic regression model found only female sex (odds ratio, 2.27; P=.02) to be associated with BP control and a trend towards an association of age with uncontrolled BP (odds ratio, 0.97; P=.06). BP control in nondiabetics was 47.8% vs 31.1% in diabetic patients (P=.02). We found that patients who attended the FQHC had a lower rate of BP control compared with the national average. Our study revealed a male sex disparity and significantly lower rate of BP control among DM patients.
高血压(HTN)在低收入群体中尤为严重。合格的联邦健康中心(FQHC)为低收入和医疗服务不足的人群提供护理。为了评估密歇根州一个 FQHC 中高血压、冠心病和/或糖尿病(DM)患者的血压(BP)控制率和预测因素,对 2006 年 1 月至 2008 年 12 月期间就诊的所有高血压、冠心病和/或糖尿病患者进行了回顾性分析。在确定的 212 名患者中,154 名有高血压病史,122 名有糖尿病史。整个队列中,38.2%的患者血压得到控制,有糖尿病的患者中 31.1%的血压得到控制。在总人群(P=.05)和糖尿病亚组(P=.02)中,血压得到控制的患者的平均年龄均低于血压未得到控制的患者。Logistic 回归模型发现,只有女性(比值比,2.27;P=.02)与血压控制相关,年龄与未控制血压呈正相关趋势(比值比,0.97;P=.06)。非糖尿病患者的血压控制率为 47.8%,而糖尿病患者为 31.1%(P=.02)。我们发现,与全国平均水平相比,到 FQHC 就诊的患者血压控制率较低。我们的研究揭示了男性性别差异,以及糖尿病患者的血压控制率显著降低。