Blood Pressure Control Among US Veterans: A Large Multi-Year Analysis of Blood Pressure Data from the VA Health Data Repository
Background—Hypertension treatment and control remain low worldwide. Strategies to improve blood pressure control have been implemented in the US and around the world for several years. This study was designed to assess improvement in blood pressure control over a ten year period in a large cohort of patients in the Department of Veterans Affairs.
Methods and Results—A cohort of 582,881 hypertensive patients and 260,924 normotensive individuals treated in 15 VA Medical Centers between 2000 and 2010 was examined. Strategies used system wide included blood pressure control as a performance measure, automatic notification to health care providers, electronic reminders and a systematic revisit schedule. The main outcome measure was the percent of hypertensive patients controlled and the level of blood pressure each month. In the hypertensive cohort (mean age 62.9 ± 13.4 years, 96.0% male) 52.3% of patients were white, 25.1% African American and 21.1% were Hispanic. Blood pressure control rates improved from 45.7% in September 2000, to 76.3% in August 2010. Improvements were similar across ethnic, racial, age and gender groups. Average blood pressure decreased from 142.6/77.1 in 2000 to 131.2/74.8 mmHg in 2010, a decrease of 11.3/2.3 mmHg (p<0.0001 for both). Systolic and diastolic BP were lower in summer as compared to winter and this trend continued through 2010. On average, percent control rates increased by 3.0% per year and were 6.8% higher in summer than winter.
Conclusions—High rates of BP control can be achieved in all age and ethnic groups and in both genders.
- Received March 3, 2011.
- Accepted March 26, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited