Physician Characteristics as Predictors of Blood Pressure Control in Patients Enrolled in the Hypertension Improvement Project (HIP)

Authors

  • Leonor Corsino MD, MHS,

    1. From the Department of Medicine, Duke University Medical Center, Durham, NC;
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  • William S. Yancy MD, MHS,

    1. From the Department of Medicine, Duke University Medical Center, Durham, NC;
    2. Center for Health Services Research in Primary Care, Durham VAMC, Durham, NC;
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  • Gregory P. Samsa PhD,

    1. Department of Biostatistics & Bioinformatics, Duke University, Durham, NC;
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  • Rowena J. Dolor MD, MHS,

    1. From the Department of Medicine, Duke University Medical Center, Durham, NC;
    2. Center for Health Services Research in Primary Care, Durham VAMC, Durham, NC;
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  • Kathryn I. Pollak PhD,

    1. Cancer Prevention, Detection, and Control Research Program, Duke University Medical Center, Durham, NC;
    2. Department of Community and Family Medicine, Duke University Medical Center, Durham, NC;
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  • Pao-Hwa Lin PhD,

    1. From the Department of Medicine, Duke University Medical Center, Durham, NC;
    2. Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC;
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  • Laura P. Svetkey MD, MHS

    1. From the Department of Medicine, Duke University Medical Center, Durham, NC;
    2. Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC;
    3. Duke Hypertension Center, Duke University Medical Center, Durham, NC
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Leonor Corsino, MD, MHS, Duke University Medical Center, Box 3451, Durham, NC 27710
E-mail: corsi002@mc.duke.edu

Abstract

The authors sought to examine the relationship between physician characteristics and patient blood pressure (BP) in participants enrolled in the Hypertension Improvement Project (HIP). In this cross-sectional study using baseline data of HIP participants, the authors used multiple linear regression to examine how patient BP was related to physician characteristics, including experience, practice patterns, and clinic load. Patients had significantly lower systolic BP (SBP) (−0.2 mm Hg for every 1% increase, P=.008) and diastolic BP (DBP) (−0.1 mm Hg for every 1% increase, P=.0007) when seen by physicians with a higher percentage of patients with hypertension. Patients had significantly higher SBP (0.8 mm Hg for every 1% increase, P=.002) when seen by physicians with a higher number of total clinic visits per day. Patients had significantly lower DBP (−4.4 mm Hg decrease, P=.0002) when seen by physicians with inpatient duties. Physician’s volume of patients with hypertension was related to better BP control. However, two indicators of a busy practice had conflicting relationships with BP control. Given the increasing time demands on physicians, future research should examine how physicians with a busy practice are able to successfully address BP in their patients. J Clin Hypertens (Greenwich). 2011;13:106–111. © 2010 Wiley Periodicals, Inc.

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