Document Type

Article

Publication Date

1-10-2024

Publication Title

American Journal of Preventive Cardiology

Volume

17

Pages

1-8

Publisher Name

Elsevier

Abstract

Objective

Hypertension quality improvement programs reduce uncontrolled blood pressure (BP) but impact may differ by sex and age.

Methods

This study examined uncontrolled BP, defined as a BP ≥ 140/90 mmHg, and therapeutic inertia, defined as absence of medication initiation or escalation during visits with uncontrolled BP, by sex and by age group (19–40, 41–65, 66–75, and 76+ years) during a 12 month follow-up period among 21, 861 patients with hypertension and ≥ two visits in primary care clinics enrolled in the American Medical Association (AMA) Measure Accurately, Act Rapidly, and Partner with Patients (MAP) BP hypertension quality improvement program.

Results

The mean age was 64.8 years (standard deviation [SD 12.8]) and ranged from 19 to 87 years; 53.6% were female. In age groups 19–40, 41–65, 66–75, 76–87 years, uncontrolled BP at the first clinic visit was present in 51.5%, 42.5%, 37.5% and 36.6% of males, respectively, and in 40.0%, 38.0%, 36.0% and 39.6% of females, respectively. Based on vital signs at the first vs. last clinic visit, the proportion of patients with uncontrolled BP in age groups 19–40, 41–65, 66–75 years declined by 19.4%, 13.5%, 10.1% and 8.7% in males, respectively, and 14.4%, 12.5%, 9.3%, and 8.4%, among females, respectively. Therapeutic inertia ranged from 66.5% and 75.9% of clinic visits among males and females age 19–40 years, to 85.6% and 84.9% of clinic visits among males and females age 76–87 years, respectively. The proportion of clinic visits with therapeutic inertia was lower among males vs. females across all age groups until age 76–87 years.

Conclusion

A quality improvement program improves BP control but declines in uncontrolled BP are larger and therapeutic inertia is lower for younger vs. older age groups and for males vs. females. More interventions are needed to reduce sex and age disparities in hypertension management.

Comments

Author Posting © The Author(s), 2024. This article is posted here by permission of Elsevier for personal use. This article was published open access in American Journal of Preventive Cardiology, VOL.17, (March 2024), https://doi.org/10.1016/j.ajpc.2023.100632

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