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在一家医院的内科门诊中,医疗保险状况会影响高血压的控制情况。

Health insurance status affects hypertension control in a hospital based internal medicine clinic.

作者信息

Oso Ayodeji A, Adefurin Abiodun, Benneman Monique M, Oso Olatunde O, Taiwo Muinat A, Adebiyi Oluwafisayo O, Oluwole Olorunkemi

机构信息

Meharry Medical College, 1005 DB Todd Blvd., Nashville, TN 37208, USA.

Nashville General Hospital, 1818 Albion St, Nashville, TN 37208, USA.

出版信息

Int J Cardiol Hypertens. 2019 Apr 11;1:100003. doi: 10.1016/j.ijchy.2019.100003. eCollection 2019 May.

Abstract

Hypertension is a worldwide disorder that contributes significantly to morbidity, mortality, and healthcare costs in both developed and developing communities. A retrospective cohort study of hypertensive patients attending the Internal Medicine continuity clinic at Nashville General Hospital (NGH) between January and December 2007 was conducted. Given the easy access to health care at NGH and affordable Blood pressure (BP) medications, we explored the ability to achieve optimal BP control <140/90 ​mmHg and evaluated which factors are associated. Of the 199 subjects, 59% achieved BP goal <140/90 ​mmHg. The mean BP was 139/80 ​mmHg. Health insurance status was associated with SBP and DBP (All P ​< ​0.046). Patients with health insurance had a 2.2 fold increased odds of achieving BP control compared to patients without health insurance (P ​= ​0.025). Furthermore, the number of BP medications used was significantly associated with SBP and DBP (All P ​< ​0.003). Patients taking more than three BP medications had a 58% reduced odds of achieving optimal BP control compared to patients taking one medication (P ​= ​0.039). Ethnicity was not associated with achieving BP control. Our study revealed the number of BP medications used and health insurance status, are factors associated with achieving BP control.

摘要

高血压是一种全球性疾病,在发达国家和发展中国家,它对发病率、死亡率及医疗费用都有显著影响。我们对2007年1月至12月在纳什维尔综合医院(NGH)内科连续性门诊就诊的高血压患者进行了一项回顾性队列研究。鉴于在NGH可方便地获得医疗服务以及有价格合理的血压(BP)药物,我们探讨了实现血压最佳控制<140/90 mmHg的能力,并评估了哪些因素与之相关。在199名受试者中,59%实现了血压目标<140/90 mmHg。平均血压为139/80 mmHg。健康保险状况与收缩压和舒张压相关(所有P<0.046)。与没有健康保险的患者相比,有健康保险的患者实现血压控制的几率增加了2.2倍(P = 0.025)。此外,使用的血压药物数量与收缩压和舒张压显著相关(所有P<0.003)。与服用一种药物的患者相比,服用三种以上血压药物的患者实现最佳血压控制的几率降低了58%(P = 0.039)。种族与实现血压控制无关。我们的研究表明,使用的血压药物数量和健康保险状况是与实现血压控制相关的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a62d/7803069/c6e05ca84d11/gr1.jpg

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