Abstract TP184: Half of All Patients With or WIthout a History of Treatment for Hypertension Fail a Blood Pressure Screening: An innovative Urban Eye Clinic Experience
Background: Innovative strategies are needed to improve blood pressure (BP) surveillance and treatment given the generally poor control in minority communities. People may be more likely to have yearly eye exams than have an annual physical.
Objective: To assess the effectiveness of co-located screening services for hypertension in an urban, university-based optometry clinic.
Methods: After IRB approval and informed consent, BPs were taken [Omron (Healthcare Kyoto, Japan) 10 Series automated monitor] on the right arm with the subjects in a seated position. Two measurements were taken 10 min apart prior to pharmacologic dilation of pupils. A brief screening history included current BP medications, presence of medical insurance, and a medical provider. Subjects whose BP was greater than a threshold of 140 systolic/85 diastolic on either of the 2 measurements were instructed to consult with their primary care provider. Patients reporting no known provider were referred for care.
Results: 138 patients were enrolled: 57% female, aged 21 to 86 yrs (mean 57.7 ± 16.27); 61% Black, 21% Caucasian, 12% Hispanic, 6% other; 91% had medical insurance and 48% were currently treated for hypertension. BP measurements > 140/85 were found in 50% (69/138). Of these 69 subjects, 41 (63%) were female. Of the uninsured, 5 of 13 (38%) exceeded the BP threshold. Among subjects currently treated for high BP, 50% exceeded the threshold. This group had a mean systolic BP = 158 (SD 6), median = 152 and a diastolic mean = 94 (SD 8), median = 92. Patients with no prior history of high BP had a mean systolic = 154 (SD 14), median =152, and a diastolic mean & median = 93 (SD 6) and they were > 2x as likely to have a reading of > 85 mmHg diastolic (n=21) vs. >140 mmHg systolic (n=54). Systolic BP showed a weak (r2 = 0.12) correlation with age; diastolic BP showed no correlation (r2 = 0.008).
Conclusions: Co-location of screening services was accepted by the patients served by this urban, academic optometry clinic. Despite being under treatment for hypertension, half the group continued to have measurements associated with at least a doubling of the risk of stroke. Our data suggest that identification of urban, minority patients at risk for stroke could be readily identified by non-traditional health care providers.
- © 2012 by American Heart Association, Inc.