Correlates of controlled hypertension in indigent, inner-city hypertensive patients

J Gen Intern Med. 1997 Jan;12(1):7-14. doi: 10.1046/j.1525-1497.1997.12107.x.


Objective: To identify correlates of controlled hypertension in a largely minority population of treated hypertensive patients.

Design: Case-control study.

Setting: Urban, public hospital.

Patients: A consecutive sample of patients who were aware of their diagnosis of hypertension for at least 1 month and had previously filled an antihypertensive prescription. Control patients had a systolic blood pressure (SBP) < or = 140 mm Hg and diastolic blood pressure (DBP) < or = 90 mm Hg, and case patients had a SBP > or = 180 mm Hg or DBP > or = 110 mm Hg.

Measurements and main results: Control subjects had a mean blood pressure (BP) of 130/80 mm Hg and case subjects had a mean BP of 193/106 mm Hg. Baseline demographic characteristics between the 88 case and the 133 control subjects were not significantly different. In a logistic regression model, after adjusting for age, gender, race, education, owning a telephone, and family income, controlled hypertension was associated with having a regular source of care (odds ratio [OR] 7.93; 95% confidence interval [CI] 3.86, 16.29), having been to a doctor in the previous 6 months (OR 4.81; 1.14, 20.31), reporting that cost was not a deterrent to buying their antihypertensive medication (OR 3.63; 1.59, 8.28), and having insurance (OR 2.15; 1.02, 4.52). Being compliant with antihypertensive medication regimens was of borderline significance (OR 1.96; 0.99, 3.88). A secondary analysis found that patients with Medicaid coverage were significantly less likely than the uninsured to report cost as a barrier to purchasing antihypertensive medications and seeing a physician.

Conclusions: The absence of out-of-pocket expenditures under Medicaid for medications and physician care may contribute significantly to BP control. Improved access to a regular source of care and increased sensitivity to medication costs for all patients may lead to improved BP control in an indigent, inner-city population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antihypertensive Agents / economics
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure Determination
  • Data Interpretation, Statistical
  • Female
  • Health Care Costs*
  • Health Knowledge, Attitudes, Practice*
  • Health Services Accessibility*
  • Hospitals, Urban
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / economics
  • Male
  • Medicaid
  • Medical Indigency
  • Middle Aged
  • Minority Groups
  • Patient Education as Topic
  • United States


  • Antihypertensive Agents