Health insurance status affects hypertension control in a hospital based internal medicine clinic

Ayodeji A Oso; Abiodun Adefurin; Monique M Benneman; Olatunde O Oso; Muinat A Taiwo; Oluwafisayo O Adebiyi; Olorunkemi Oluwole

doi:10.1016/j.ijchy.2019.100003

Health insurance status affects hypertension control in a hospital based internal medicine clinic

Int J Cardiol Hypertens. 2019 Apr 11:1:100003. doi: 10.1016/j.ijchy.2019.100003. eCollection 2019 May.

Authors

Ayodeji A Oso^{1

2}, Abiodun Adefurin¹, Monique M Benneman^{1

2}, Olatunde O Oso¹, Muinat A Taiwo¹, Oluwafisayo O Adebiyi^{1

3}, Olorunkemi Oluwole^{1

4}

Affiliations

¹ Meharry Medical College, 1005 DB Todd Blvd., Nashville, TN 37208, USA.
² Nashville General Hospital, 1818 Albion St, Nashville, TN 37208, USA.
³ Indiana University School of Medicine, Indianapolis, IN 46202, USA.
⁴ Medical University of South Carolina, Charleston, SC 29425, USA.

Abstract

Hypertension is a worldwide disorder that contributes significantly to morbidity, mortality, and healthcare costs in both developed and developing communities. A retrospective cohort study of hypertensive patients attending the Internal Medicine continuity clinic at Nashville General Hospital (NGH) between January and December 2007 was conducted. Given the easy access to health care at NGH and affordable Blood pressure (BP) medications, we explored the ability to achieve optimal BP control <140/90 mmHg and evaluated which factors are associated. Of the 199 subjects, 59% achieved BP goal <140/90 mmHg. The mean BP was 139/80 mmHg. Health insurance status was associated with SBP and DBP (All P < 0.046). Patients with health insurance had a 2.2 fold increased odds of achieving BP control compared to patients without health insurance (P = 0.025). Furthermore, the number of BP medications used was significantly associated with SBP and DBP (All P < 0.003). Patients taking more than three BP medications had a 58% reduced odds of achieving optimal BP control compared to patients taking one medication (P = 0.039). Ethnicity was not associated with achieving BP control. Our study revealed the number of BP medications used and health insurance status, are factors associated with achieving BP control.

Keywords: Blood pressure control; Ethnicity; Health care access; Health insurance; Hypertension.