Predictors of Uncontrolled Hypertension in the Stroke Belt
Article first published online: 9 MAY 2013
© 2013 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 15, Issue 8, pages 562–569, August 2013
How to Cite
J Clin Hypertens (Greenwich). 2013;15:562–569. ©2013 Wiley Periodicals, Inc.
- Issue published online: 24 JUL 2013
- Article first published online: 9 MAY 2013
- Manuscript Accepted: 30 MAR 2013
- Manuscript Revised: 22 MAR 2013
- Manuscript Received: 23 JAN 2013
Inadequate control of high systolic blood pressure in older adults has been largely attributable to poor control of overall hypertension (HTN). The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines emphasize the importance of controlling isolated systolic HTN in older adults. The study examined demographics, self-reported health information, and clinical measures as predictors of uncontrolled HTN among individuals taking antihypertensive medications. The Community Initiative to Eliminate Stroke, a stroke risk factor screening and prevention project, collected data in two North Carolina counties. Statistical modeling of predictors included odds ratios (ORs) and logistic regression analyses. Of the 2663 participants, 43.5% and 22.8% had uncontrolled systolic and diastolic HTN, respectively. African Americans were more likely to have uncontrolled systolic (60%) or diastolic HTN (70.9%) compared with whites (40% and 29.1%, respectively). Participants 55 years and older were more likely to have uncontrolled systolic HTN compared with younger individuals. Regression analyses showed that race (OR, 1.239; P=.00), age (OR, 1.683; P=.00), and nonadherence with medications (OR, 2.593; P=.00) were significant predictors of uncontrolled systolic HTN. Future interventions should focus on improving management of isolated systolic HTN in older adults and African Americans to increase overall control of HTN.