J Clin Outcomes Manage
Hypertension and hyperlipidemia management in patients treated at community health centers
Kirchhoff AC, Drum ML, Zhang JX, Schlichting JA, Levie J, Harrison JF, Lippold S, Schaefer CT, Chin MH
Abstract Objective: To assess hypertension and hyperlipidemia management in community health centers during a time of guideline revision and increased quality improvement efforts. Design: Retrospective review of medical records. Patients and setting: 2976 patients with hypertension and/or hyperlipidemia attending health centers in the Midwest. Measurement: Blood pressure levels and low-density lipoprotein (LDL) cholesterol levels in 2000 and 2002. Results: Hypertension outcomes improved for specific clinical subgroups. Hypertensive patients with 1 or more cardiovascular risk factors demonstrated significant improvement (34% vs. 45% controlled at < 140/90 mm Hg; P = 0.02). Hypertension control for persons with diabetes, renal failure, and heart failure in-creased (16% vs. 28% controlled at < 130/85 mm Hg; P = 0.006). LDL cholesterol control increased significantly for patients with 2 or more risk factors (39% vs. 58% controlled at < 130 mg/dL; P = 0.008). Other clinical subgroups showed trends toward better control, although there was insufficient power to detect significant differences for these groups. Conclusion: Hypertension and hyperlipidemia outcomes improved for some risk groups; however, ongoing quality improvement is necessary.
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