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- W2124106597 abstract "Aggressive treatment with multiple medications to achieve lower blood pressure targets is advocated by the JNC VI and other national guidelines. In the existing systems of care, specialty or referral clinics emphasize a disease specific focus. As one of the twenty-one Consortium for South Eastern Hypertension Control (COSEHC) cardiovascular centers of excellence, we reviewed our site-specific clinic registry for established patients with three or more visits, in order to define blood pressure (BP) control rates and co-morbidity. All clinical and demographic data were transmitted to a centralized on-line database. From the135 charts randomly selected over a 6-month period as a representative sample,49 were included in this analysis: 77% were African Americans, 10% Hispanics, 3% Caucasians and 9 % other racial groups. Co-morbid conditions were Left Ventricular Hypertrophy (LVH) in 60%,congestive heart failure (CHF) 43%, diabetes mellitus 41%, myocardial infarction 20%, peripheral vascular disease 10% and cerebro-vascular disease 6%.Diabetes control, as defined by glycosylated hemoglobin levels, was 7.4± 3.6% and did not reach recommended targets. Patterns of medication use showed that 70% were on angiotensin converting enzyme inhibitors (ACEI),65% on diuretics, 60% on beta blockers, 40% on calcium channel blockers, 40% on statins and 22% on angiotensin receptor blockers(ARBs). Systolic BP ( mmHg) for each of the four consecutive visits shown as mean ± SD were 150±21, 138± 27, 142 ± 21 and 139± 25. The mean ± SD for diastolic BP over the four visits were 86 ± 16; 77± 15; 77± 12 and 78± 15. The proportion of patients reaching preset goal systolic BP less than 140 mmHg by the last visit was 55% and 70% achieved diastolic BP less than 90 mmHg. In this high-risk cohort with significant co-morbidity, control rates compare well with National rates; however, they fall short of the goals set for high-risk patients with diabetes mellitus or coronary artery disease risk equivalent. Strategies that integrate a comprehensive approach for cardiovascular risk management should be developed and tested in such high-risk patients. Such an approach should minimize fragmentation of care and utilization of services." @default.
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- W2124106597 date "2003-05-01" @default.
- W2124106597 modified "2023-09-27" @default.
- W2124106597 title "Hypertension treatment outcomes in a specialty care practice" @default.
- W2124106597 doi "https://doi.org/10.1016/s0895-7061(03)00714-3" @default.
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