Ashman Jill J, Rui Pinyao, Schappert Susan M, Strashny Alexander
Natl Health Stat Report. 2017 Sep(106):1-14.
Objective-This report describes the demographic, state, and regional differences in hypertension control and pharmaceutical treatment among visits to primary care physicians made by hypertensive adults during 2013-2014. Methods-Data are from the 2013-2014 National Ambulatory Medical Care Survey (NAMCS), a nationally representative survey of visits to nonfederal, office-based physicians. The sample design for the 2013-2014 NAMCS included oversampling in selected states. Estimates are provided for the 18 states oversampled in both years. Estimates are also presented for the nine census divisions. The study population includes all primary care physician visits made by nonpregnant adults who have hypertension, as defined by documentation of hypertension in their medical record. Hypertensive visits indicating hypertension control as well as those with mention of a hypertensive medication were examined by selected demographic characteristics as well as by region and state. Sample weights were applied to each case to provide national estimates of health care utilization. Results-During 2013-2014, in the United States, hypertension control was indicated [a blood pressure (BP) measurement of less than 140/90 mm Hg] at an estimated 66.0% of hypertensive visits. There was mention of at least one hypertensive medication documented in the medical record at 72.0% of hypertensive visits. Hypertension control was indicated at a lower percentage of hypertensive visits made by non-Hispanic black persons (57.4%) than hypertensive visits made by all other racial or ethnic groups. Hypertension was under control or there was mention of a hypertensive medication at a lower percentage of hypertensive visits made by adults aged 18-44 than hypertensive visits by older adults. The percentage of visits with an indication of hypertension control varied widely by state (ranging from 53.7% in Tennessee to 73.2% in Florida) and region (ranging from 60.1% in the East South Central division to 71.1% in the New England division). Among the 18 states, the percentage of hypertensive visits that had mention of a hypertensive medication ranged from 57.1% in Georgia to 85.0% in Washington. Conclusion- The demographic and geographical differences identified in this report may help inform state and local policies aimed at controlling hypertension.
目的——本报告描述了2013 - 2014年高血压成人患者在基层医疗医生处就诊时，高血压控制及药物治疗方面的人口统计学、州及地区差异。方法——数据来自2013 - 2014年国家门诊医疗调查（NAMCS），这是一项针对非联邦、基于办公室的医生就诊情况的全国代表性调查。2013 - 2014年NAMCS的抽样设计包括在选定州进行过抽样。提供了两年都进行过抽样的18个州的估计数据。还给出了九个普查分区的估计数据。研究人群包括所有有高血压的非孕妇成人患者在基层医疗医生处的就诊情况，高血压定义为其病历中有高血压记录。根据选定的人口统计学特征以及地区和州，对表明高血压得到控制的就诊情况以及提及高血压药物的就诊情况进行了检查。对每个病例应用样本权重以提供全国医疗保健利用情况的估计。结果——在2013 - 2014年期间，在美国，估计有66.0%的高血压就诊病例显示高血压得到控制（血压测量值低于140/90毫米汞柱）。病历中有至少一种高血压药物记录的高血压就诊病例占72.0%。非西班牙裔黑人患者的高血压就诊病例中显示高血压得到控制的比例（57.4%）低于所有其他种族或族裔群体的高血压就诊病例。18 - 44岁成年人的高血压就诊病例中高血压得到控制或提及高血压药物的比例低于老年成年人的高血压就诊病例。表明高血压得到控制的就诊比例在各州差异很大（从田纳西州的53.7%到佛罗里达州的73.2%），在各地区也有差异（从东中南部地区的60.1%到新英格兰地区的71.1%）。在这18个州中，提及高血压药物的高血压就诊病例比例从佐治亚州的57.1%到华盛顿州的85.0%不等。结论——本报告中确定的人口统计学和地理差异可能有助于为旨在控制高血压的州和地方政策提供信息。
